What is Vaginitis?
Vaginitis is a general term used to describe an infection or inflammation of the vagina. Vaginitis can result from a vaginal infection caused by organisms such as bacteria, yeasts and viruses as well from an irritation caused by chemicals in products or clothing that comes in close contact with this area. Sometimes, vaginitis can result be transmitted between sexual partners.
What causes Vaginitis?
- Use of antibiotics
- Changes in hormone levels due to pregnancy, breastfeeding or menopause
- Sexual intercourse
One out of every three women will experience a yeast or bacterial infection at some point during their lifetime. It can affect women of all ages, but most commonly affects those in their reproductive years.
Types of Vaginitis
The three most common types of vaginal infections are Bacterial Vaginosis (BV), yeast infection and Trichomoniasis.
While yeast infection may come to mind, bacterial vaginosis (BV) is actually the most common vaginal infection affecting women of reproductive age.” BV is caused by a combination of several bacteria which overgrow when the pH balance of the vagina is upset. A healthy vaginal pH falls between 3.5 and 4.8.
Hygiene, diet, medications and chemicals such as those found in some creams and douches, can upset this delicate pH balance making the vagina more hospitable to bacterial and yeast overgrowth. To help maintain a healthy vaginal pH, a woman should only clean her vagina and vulva with products free of suspected irritants, glycerin and parabens.
Fifty percent of women with BV have no idea they have the infection. That is because there are typically no symptoms and it often does not get discovered until a woman goes for her annual gynecologic exam. If there are symptoms present, a woman might experience:
- A grayish-white or discolored discharge that smells “fishy”
- A very strong smell after having sex
- An itchy, sore vagina
BV must be treated with drugs prescribed by a doctor. Over-the-counter remedies are typically not effective at curing it. BV is considered a serious health concern because it can increase a woman’s chance of getting a sexually transmitted disease as well as increase her risk of developing a pelvic inflammatory disease (PID) following surgery (such as a hysterectomy).
Vaginal yeast infections are caused by a type of fungus, usually Candida albicans. Candida normally inhabits the vagina as well as the mouth and digestive tracts of both men and women. It is only when these organisms grow out of control that they become problematic. A recent course of antibiotics, for example, kills off both the bad and good bacteria that colonize the body. When good bacteria are destroyed, there is nothing to keep the growth of opportunistic Candida in check, and a yeast infection often results.
Fortunately, it is easy to replace the flora of healthy vaginal and gut bacteria by taking probiotics as well as by eating yogurt containing active, healthy strains of bacteria.
Yeast infections can also be caused by uncontrolled diabetes, the changing hormones of pregnancy and oral contraceptives (birth control pills).
These infections usually cause intense itching and redness of the vagina and vulva. There can also be a discharge present that resembles cottage cheese.
Yeast infections are usually treated with over-the-counter medical creams or suppositories, although oral medication is also available by prescription.
To prevent yeast infections, one is advised to:
- Wear loose clothing made from natural fibers (cotton, linen, silk).
- Avoid wearing tight pants.
- Refrain from douching (it can kill bacteria that control fungus).
- Limit the use of feminine deodorant.
- Limit the use of deodorant tampons or pads.
- Change out of wet clothing, especially bathing suits, as soon as possible.
- Avoid frequent use of hot tubs.
- Wash underwear in hot water.
- Eat a well-balanced diet low in sugar (sugar fuels Candida).
- Eat yogurt.
- Keep blood sugar levels in check if diabetes is an issue.
Trichomoniasis & Chlamydia
There are several infections that are transmitted through sexual relations, and trichomoniasis and chlamydia are commonly found among them.
Trichomoniasis is caused by a microscopic, one-celled parasite called Trichomonas vaginalis. This infection spreads during sexual intercourse with someone who already has the infection. In men, the organism usually infects the urinary tract, but often causes no symptoms. In women, it typically infects the vagina, and may cause the following symptoms:
- Frothy, greenish-yellow discharge
- Foul smell
- Itching and soreness of the vulva and vagina
- Burning during urination
- Lower abdomen and vaginal pain with intercourse
- Symptoms that worsen after a menstrual cycle
Chlamydia is another sexually transmitted form of vaginitis. Typically, there are no symptoms with this infection, and it often goes undiagnosed until a pelvic exam is performed. A vaginal discharge may or may not be present. Light bleeding after intercourse and discomfort in the pelvis are common. Chlamydia is most likely to be seen in women between the ages of 18-35 who have multiple sexual partners.
If Chlamydia is left untreated, it could potentially damage a woman’s reproductive organs and affect her ability to become pregnant.
Treatments, in general, can vary depending on the cause of the vaginitis and may require an oral antibiotic and possibly a pill, cream or gel to be applied, or inserted, into the vagina as prescribed.
Usually, vaginal infections do not cause serious complications. In pregnant women, however, symptomatic bacterial vaginosis and trichomoniasis have been associated with premature deliveries and low birth weight babies.
Other viruses that can cause Vaginitis
Besides bacteria, there are also viruses that can cause sexually transmitted vaginitis. These viruses include the herpes simplex virus and the humanpapilloma virus (HPV).
Herpes is associated with painful sores usually seen on the vulva or the vagina. Occasionally, the sores are located deeper in the vagina and are only seen during a gynecologic exam.
Humanpapilloma Virus (HPV)
HPV may cause warts to grow in the vagina, rectum, vulva, or around the groin. These genital warts can vary in color from white to gray or even pink to purple. Sometimes, warts are not visible at all, and the only way to render a diagnosis is to have a Pap smear or a specialized HPV test.
Sometimes, a woman can experience itching, burning, and even a vaginal discharge without having an infection at all. In that case, she might be having an irritation or allergic reaction to vaginal sprays, douches and spermicidal products, or perfumed soaps, detergents and fabric softeners.
Another non-infectious type of vaginitis, called atrophic vaginitis, can be due to a decrease in hormones during menopause, or if the ovaries have been surgically removed. Atrophic vaginitis is associated with dryness of the vagina and pain during sexual intercourse.
Non-infectious vaginitis is treated by eliminating the probable cause. If a patient recently started using a new soap, laundry detergent, vaginal spray, sanitary napkin or tampon and is experiencing the symptoms of an infection, it is highly likely this is what is causing the symptoms. Patients would be advised to first stop using the new product to see if the symptoms go away on their own. If the vaginitis is due to hormonal changes, a low-dose, bio-identical estrogen cream may be prescribed.
Proper diagnosis and visiting your doctor
The key to proper treatment of vaginal infections is making a proper diagnosis. It helps if a woman pays close attention to her symptoms in order to assist the healthcare provider in diagnosing the condition and determining the best treatment. It is best to see one’s doctor before self-treating with any over-the-counter medications.