Vaginitis: Symptoms, Causes and Treatment

Maintaining good intimate hygiene, using non-perfumed soaps, and wearing loose-fitting underwear are habits that help prevent this condition. We'll tell you everything you should know.
Vaginitis: Symptoms, Causes and Treatment

Written by Daniela Andarcia

Last update: 16 December, 2022

Vaginitis, or vulvovaginitis, is a common condition characterized by inflammation in the vaginal area. It can cause discharge, pain, burning, itching, and even bleeding from the area.

It often develops due to a bacterial infection or a change in the normal balance of the vaginal flora, although it can also be caused by Trichomonas, a parasite. A culture could reveal the origin of vaginitis in women and the treatment will depend on the causative agent.

Symptoms of vaginitis

Vaginitis can affect women at any age, even during childhood. In general, the symptoms of this condition are painful and uncomfortable, so it should be treated as soon as they first appear, in order to avoid complications.

Among the most common signs are the following:

  • Irritation in the genital area
  • Bad vaginal odor
  • Vaginal itching
  • Pain or discomfort when urinating, known as dysuria
  • Dyspareunia (painful sexual intercourse)
  • Vaginal bleeding
  • Swelling, tenderness, and redness in the vaginal area
  • The urgency to urinate, even in small amounts
  • Thick or watery discharge with a color that varies between white, gray, and green.

The vagina is the muscular canal that begins from the cervix to the outside of the body. It is around 6 to 7 inches long. Vaginitis can affect that entire area and even the labia.

Urinary urgency in a woman with vaginitis.
Urinary urgency can be a symptom of vaginitis in women and not of urinary infection.

Causes

According to a study published in American Family Physician, vaginitis is one of the most common infections in gynecological diagnoses. 90% of cases are for infectious vaginitis, that is, cases linked to candidiasis, bacterial vaginosis, or trichomoniasis.

This condition can also be due to gonorrhea, Mycoplasma infection, herpes, or Chlamydia, and even the rare Campylobacter colonization. On the other hand, it could develop due to an abrasion or trauma in the area of the vagina that serves as a gateway for pathogenic microorganisms to enter.

When there’s vaginal dryness, the area is prone to experiencing vaginitis. Girls who are transitioning to puberty, as well as menopausal and postmenopausal women, are susceptible to a reduction in the moisture of this mucosa.

Likewise, an allergy to some type of condom, spermicides, douches, a particular soap, a medicine, or a tampon shouldn’t be ruled out. Among the risk factors are the following:

  • Taking antibiotics
  • Being pregnant
  • Having diabetes
  • Using douches or sprays
  • Having low estrogen levels (for a pathological reason or for a natural cause, such as menopause)
  • Wearing tight underwear or pants (jeans).

Keep in mind that certain yeast infections and bacterial vaginosis are classified as vulvovaginitis, but they aren’t transmitted through sexual intercourse. However, sexually active women are more likely to develop the condition.

Finally, there is scientific evidence that women who have sex with multiple partners have a higher risk of developing bacterial vaginitis. Similarly, they have a 60% higher risk of developing vaginosis if the sexual partner is female.

Some types of vaginitis

According to the causes that we have been listing, we can thus classify vaginitis into several types. The most relevant are the following:

  • Bacterial vaginosis: when the balance of the normal flora is broken and there’s an excess of certain bacterial strains in the vagina.
  • Vaginal atrophy: this occurs when the lining of the vagina thins due to decreased estrogen. It usually occurs during menopause.
  • Candidiasis: this is caused by the fungus Candida albicans.
  • Trichomonas vaginalis: this unicellular protozoan parasite usually generates a yellowish discharge with a very particular and characteristic odor.

Diagnosis

When you go to the doctor, they may ask you some routine questions. You’ll be asked for information about your sexual history and the symptoms you have had, if you have burning when urinating, or if it hurts when you have intercourse. They will also likely perform a pelvic and vaginal physical exam and ask you to do a urine test.

All this is in order to evaluate if there are infectious organisms that explain the symptoms or if you experience an inflammatory condition without infection. Likewise, the doctor can take a sample of the vaginal discharge to study the pH levels, the smell, and the appearance, culminating with a culture.

If you’re pregnant, you should inform your doctor, as the infection could affect the fetus. Similarly, the prescription, if necessary, must be made for a drug that does not affect pregnancy.

Vaginitis in pregnancy.
Vaginitis in pregnancy can be a risk factor for preterm delivery or intrauterine growth restriction.

Treatment

The doctor will prescribe the treatment depending on the cause of the vulvovaginitis. When the infection is due to a fungus, clotrimazole may be prescribed. In the case of bacterial vaginitis, antibiotics will be recommended orally or in the form of vaginal ovules.

To treat severe irritations, some professionals recommend corticosteroid creams. However, this should be used for a limited time. If the inflammation is due to an allergic reaction, antihistamines will be the preferred form of treatment. And if the vaginitis is due to low levels of estrogen in the body, a topical cream with the hormone might be enough.

It’s recommended that you follow the doctor’s instructions, the prescribed doses, and the prescribed time.

Prevention of vaginitis

Some steps may help prevent vulvovaginitis. These include maintaining good intimate hygiene, cleaning the genitals from front to back, using mild, fragrance-free soaps, wearing loose-fitting underwear, and using condoms during sex.

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