Vaginitis

Vaginitis is inflammation of the vagina. It can cause itching, pain and abnormal discharge. Vaginitis is typically caused by a change in the normal balance of bacteria that live in a woman's vagina, or by an infection. It is a common condition affecting women of all ages. Studies have shown that at least 40 percent of the time women misdiagnose the type of vaginitis they are experiencing; therefore, it is important to see a doctor for diagnosis and treatment of vaginitis.

The most common types of vaginitis are:

Bacterial vaginosis. Caused by an overgrowth of bacteria normally present in the vagina, upsetting the natural balance of bacteria that live in the vagina. Bacterial vaginosis may cause a thin, milky discharge from the vagina that has a "fishy" odor. Many women with bacterial vaginosis have no symptoms and only discover they have it during a routine gynecologic exam.

Yeast infections. Caused when too much of the naturally occurring candida fungus grows in the vagina. Yeast infections may produce a thick, white, odorless vaginal discharge similar in appearance to cottage cheese in about 10 percent of cases. Yeast infections usually cause the vagina and vulva (the area outside the vagina) to become itchy and red.

Trichomoniasis. A sexually transmitted disease caused by a parasite. It can cause vaginal burning, and soreness of the vagina and vulva, a frothy, greenish-yellow discharge, and burning during urination. Many women, however, do not develop any symptoms. This type of vaginitis can be transmitted through sexual intercourse; therefore the sexual partner must be treated at the same time as the woman.

Atrophic vaginitis. Caused when female hormone levels are low, such as during breastfeeding and after menopause. The vaginal tissues become thinner and drier, which may lead to itching, burning or pain.

A woman's vagina normally produces a small amount of clear or cloudy white fluid every day, known as discharge, that passes from the body. This discharge keeps the tissue moist and healthy. It is normal for the amount and color of the vaginal discharge to change throughout the menstrual cycle.

The vagina also contains many organisms, such as bacteria and yeast, that are important to its normal function. A change in the normal balance of either yeast or bacteria can result in vaginitis. Factors that can lead to an imbalance include:

• Antibiotics
• Changes in hormone levels due to pregnancy, breastfeeding or menopause
• Douching
• Spermicides
• Sexual intercourse
• Infection

If a change in the normal balance occurs, the lining of the vagina may become inflamed.

While symptoms vary depending on what is causing the infection or inflammation, in general vaginitis symptoms may include:

• Change in color, odor or amount of discharge
• Vaginal itching or irritation
• Pain during intercourse
• Burning during urination
• Light vaginal bleeding

In some cases, women with vaginitis have no symptoms at all.

Diagnosis starts with a thorough medical history and detailed discussion of your symptoms. A pelvic exam will be conducted and a vaginal discharge sample will be taken and tested to confirm vaginitis and determine the specific type, ensuring proper treatment. You may be asked to avoid douching, sexual intercourse or using any vaginal medications before your visit, for accurate test results.

There are a number of steps you can take to reduce the risk of getting vaginitis, including:

• Use plain water to clean the vulva; avoid soaps and detergents, which can change the normal balance of organisms inside the vagina
• Thoroughly clean diaphragms, cervical caps and spermicide applicators after each use
• Use condoms during sex
• If you get yeast infections often, avoid clothes that hold in heat and moisture, such as pantyhose without a cotton lining, nylon panties or tight jeans.

Treatment depends on the type of vaginitis. Treatment strategies include:

Bacterial vaginosis. Prescription antibiotics or vaginal gels/creams

Yeast infections. Antifungal cream or suppository inserted into the vagina, or oral antifungal medication. While over-the-counter treatments are more convenient and less costly than a doctor visit, it's best to see a healthcare professional the first time you have symptoms to ensure proper diagnosis and treatment.

Trichomoniasis. Prescription antibiotics for the patient and her sexual partner; avoid sexual contact until treatment is completed

Atrophic vaginitis. Estrogen creams, tablets or rings available by prescription

In infrequent types of vaginitis, various other agents are used. All treatments should be followed according to the instructions, even if the symptoms go away before treatment is completed.