Vaginitis

Vaginal Infections by WebMD

"Vaginitis" is a medical term used to describe various conditions that cause infection or inflammation of the vagina. Vulvovaginitis refers to inflammation of both the vagina and vulva (the external female genitals). These conditions can result from a vaginal infection caused by organisms such as bacteria, yeast, or viruses, as well as by irritations from chemicals in creams, sprays, or even clothing that is in contact with this area. In some cases, vaginitis results from organisms that are passed between sexual partners.

What Are the Symptoms of a Vaginal Infection?

The symptoms of a vaginal infection can vary depending on what is causing it. Some women have no symptoms at all. Some of the more common symptoms of vaginitis include:

Abnormal vaginal discharge with an unpleasant odor.
Burning during urination.
Itching around the outside of the vagina.
Discomfort during intercourse.
Is Vaginal Discharge Normal?

A woman's vagina normally produces a discharge that usually is described as clear or slightly cloudy, non-irritating, and odor-free. During the normal menstrual cycle, the amount and consistency of discharge can vary. At one time of the month there may be a small amount of a very thin or watery discharge; and at another time, a more extensive thicker discharge may appear. All of these descriptions could be considered normal.

A vaginal discharge that has an odor or that is irritating usually is considered an abnormal discharge. The irritation might be itching or burning, or both. The itching may be present at any time of the day, but it often is most bothersome at night. These symptoms often are made worse by sexual intercourse. It is important to see your doctor if there has been a change in the amount, color, or smell of the discharge.

What Are the Most Common Types of Vaginal Infections?

The six most common types of vaginal infections are:

Candida or "yeast" infections.
Bacterial vaginosis.
Trichomoniasis vaginitis.
Chlamydia vaginitis.
Viral vaginitis.
Non-infectious vaginitis.
Although each of these vaginal infections can have different symptoms, it is not always easy for a woman to figure out which type she has. In fact, diagnosis can even be tricky for an experienced doctor. Part of the problem is that sometimes more than one type of infection can be present at the same time. And, an infection may even be present without any symptoms at all.

To help you better understand these six major causes of vaginitis, let's look briefly at each one of them and how they are treated.

What Is Candida or a Vaginal "Yeast" Infection?

Yeast infections of the vagina are what most women think of when they hear the term "vaginitis." Vaginal yeast infections are caused by one of the many species of fungus called Candida. Candida normally live in small numbers in the vagina, as well as in the mouth and digestive tract, of both men and women.

Yeast infections can produce a thick, white vaginal discharge with the consistency of cottage cheese although vaginal discharge may not always be present. Yeast infections usually cause the vagina and the vulva to be very itchy and red.

Are Vaginal Yeast Infections Spread Through Sex?

Yeast infections are not usually transmitted through sexual intercourse and are not considered a sexually transmitted disease.

What Increases the Risk of Vaginal Yeast Infections?

A few things will increase your risk of getting a yeast infection, including:

Recent treatment with antibiotics. For example, a woman may take an antibiotic to treat an infection, and the antibiotic kills her body's good bacteria that normally keep the yeast in balance. As a result, the yeast overgrows and causes the infection.
Uncontrolled diabetes. This allows for too much sugar in the urine and vagina.
Pregnancy which changes hormone levels.
Other factors include:

Oral contraceptives (birth control pills).
Disorders affecting the immune system.
Thyroid or endocrine disorders.
Corticosteroid therapy.


How Are Vaginal Yeast Infections Treated?

Yeast infections are most often treated with medicine that you put into your vagina. This medicine may be in cream or suppository form and many are available over-the-counter. Medicine in a pill form that you take by mouth is also available by prescription.

What Should I Do to Prevent Vaginal Yeast Infections?

To prevent yeast infections, you should:

Wear loose clothing made from natural fibers (cotton, linen, silk).
Avoid wearing tight pants.
Don't douche. (Douching can kill bacteria that control fungus.)
Limit the use of feminine deodorant.
Limit the use of deodorant tampons or pads to the times when you need them.
Change out of wet clothing, especially bathing suits, as soon as you can.
Avoid frequent hot tub baths.
Wash underwear in hot water.
Eat a well-balanced diet.
Eat yogurt.
If you have diabetes, keep your blood sugar level as close to normal as possible.
If you get frequent yeast infections, tell your doctor. He or she may need to do certain tests to rule out other medical conditions.

What Is Bacterial Vaginosis?

Although "yeast" is the name most women think of when they think of vaginal infections, bacterial vaginosis (BV) is the most common type of vaginal infection in women of reproductive age. BV is caused by a combination of several bacteria. These bacteria seem to overgrow in much the same way as do Candida when the vaginal balance is upset. The exact reason for this overgrowth is not known.

Is Bacterial Vaginosis Spread Through Sex?

Bacterial vaginosis is not transmitted through sexual intercourse but is more common in women who are sexually active. It is also not a serious health concern but can increase a woman's risk of developing other sexually transmitted diseases and can increase the risk of pelvic inflammatory disease (PID) following surgical procedures such as abortion and hysterectomy. Some studies have shown an increased risk of early labor and premature births in women who have the infection during pregnancy. However, more recent investigations do not support this relationship.

What Are the Symptoms of Bacterial Vaginosis?

Up to 50% of the women who have bacterial vaginosis do not have any symptoms. Most women learn they have the infection during their annual gynecologic exam. But if symptoms appear, they can include:

White or discolored discharge.
Discharge that smells "fishy" that is often strongest after sex.
Pain during urination.
Itchy and sore vagina.


How Is Bacterial Vaginosis Diagnosed?

Your doctor can tell you if you have bacterial vaginosis. He or she will examine you and will take a sample of fluid from your vagina. The fluid is viewed under a microscope. In most cases, your doctor can tell right away if you have BV.

What Is the Treatment for Bacterial Vaginosis?

Bacterial vaginosis can only be treated with drugs ordered by your doctor. Over-the-counter remedies will not cure BV. The most common drugs prescribed for BV are called metronidazole (Flagyl) and clindamycin (Cleocin). These medications may be taken as a pill or used as a vaginal cream or gel.

Should I Be Treated for Bacterial Vaginosis if I Am Pregnant?

Maybe. But some medications for bacterial vaginosis should not be taken during the first three months of pregnancy. Tell your doctor if you are pregnant. Also let your doctor know if you think that you might be pregnant. You and your doctor should discuss whether or not the infection should be treated.

How Can I Protect Myself From Bacterial Vaginosis?

Ways to prevent bacterial vaginosis are not yet known. Female hygiene products like douches and deodorants will not cure the infection. These products may even make the infection worse.

What Vaginal Infections Are Spread Through Sex?

There are several vaginal infections that are transmitted through sexual contact. Trichomoniasis, caused by a tiny single-celled organism that infects the vagina, can cause a frothy, greenish-yellow discharge. Often this discharge will have a foul smell. Women with trichomonal vaginitis may complain of itching and soreness of the vagina and vulva, as well as burning during urination. In addition, there can be discomfort in the lower abdomen and vaginal pain with intercourse. These symptoms may be worse after the menstrual period. Many women, however, do not develop any symptoms.

Chlamydia is another sexually transmitted form of vaginitis. Unfortunately, most women with chlamydia infection do not have symptoms, which makes diagnosis difficult. A vaginal discharge is sometimes present, but not always. More often, a woman might experience light bleeding, especially after intercourse, and she may have pain in the lower abdomen and pelvis. Chlamydial vaginitis is most common in young women (18-35 years) who have multiple sexual partners. If you fit this description, you should request screening for chlamydia during your annual checkup. If left untreated, chlamydia can cause damage to a woman's reproductive organs, and can make it difficult for a woman to become pregnant.

Several sexually transmitted viruses cause vaginitis, including the herpes simplex virus and the humanpapilloma virus (HPV). The primary symptom of herpes is pain associated with lesions or "sores." These sores usually are visible on the vulva or the vagina but occasionally are deep inside the vagina and can only be seen during a gynecologic exam.

HPV, sometimes referred to as genital warts, can cause warts to grow in the vagina, rectum, vulva, or groin. These warts, when visible, usually are white to gray in color, but they may be pink or purple. When warts are not visible, a Pap smear or a more specialized HPV test may be the only way to detect the virus.

What Is Non-Infectious Vaginitis?

Occasionally, a woman can have itching, burning, and even a vaginal discharge without having an infection. The most common cause is an allergic reaction or irritation from vaginal sprays, douches, or spermicidal products. The skin around the vagina also can be sensitive to perfumed soaps, detergents, and fabric softeners.

Another non-infectious form of vaginitis results from a decrease in hormones because of menopause or because of surgery that removes the ovaries. In this form, the vagina becomes dry. This is referred to as atrophic vaginitis. The woman may notice pain, especially with sexual intercourse, as well as vaginal itching and burning.

How Are Vaginal Infections Treated?

The key to proper treatment of vaginal infections is proper diagnosis. This is not always easy since the same symptoms can exist in different forms of vaginitis. You can greatly assist your doctor by paying close attention to exactly which symptoms you have and when they occur, along with a description of the color, consistency, amount, and smell of any abnormal discharge. Do not douche before your office or clinic visit; it will make accurate testing difficult or impossible. Some doctors ask that you abstain from sex for 24 hours before your appointment.

Because different types of vaginitis have different causes, the treatment needs to be specific to the type of vaginitis present. It is best to see your doctor before self-treating with over-the-counter medications.

"Non-infectious" vaginitis is treated by changing the probable cause. If you recently changed your soap or laundry detergent or have added a fabric softener, you might consider stopping the new product to see if the symptoms improve. The same instruction would apply to a new vaginal spray, douche, sanitary napkin, or tampon. If the vaginitis is due to hormonal changes, estrogen may be prescribed to help reduce symptoms.

How Can I Prevent Vaginal Infections?

There are certain things that you can do to decrease the chance of getting vaginal infections. If you suffer from yeast infections, it usually is helpful to avoid garments that hold in heat and moisture. The wearing of nylon panties, pantyhose without a cotton panel, and tight jeans can lead to yeast infections. Good hygiene also is important. In addition, doctors have found that if a woman eats yogurt that contains active cultures (read the label) she may get fewer infections.

Because they can cause vaginal irritation, most doctors do not recommend vaginal sprays or heavily perfumed soaps for cleansing this area. Likewise, douching may cause irritation or, more importantly, may hide a vaginal infection. Douching also removes the healthy bacteria that help keep the vagina clean. Removing these bacteria can result in, or worsen, vaginitis.

Safe sexual practices can help prevent the passing of diseases between partners. The use of condoms is particularly important.

If you are approaching menopause, have had your ovaries removed or have low levels of estrogen for any reason, discuss with your doctor the use of estrogen in the form of pills, creams, or vaginal rings to keep the vagina lubricated and healthy.

Good health habits are important. Have a complete gynecologic exam, including a Pap smear every year unless otherwise directed by your doctor. If you have multiple sexual partners, you should request screening for sexually transmitted diseases.

When Should I Call my Doctor About a Vaginal Infection?

You should call your doctor any time if:

Your vaginal discharge changes color, becomes heavier or smells different.
You notice itching, burning, swelling or soreness around the vagina.