Vaginitis can be caused by different factors: overgrowth of yeast, overgrowth of bacteria, changes in hormone levels due to pregnancy, breastfeeding or menopause, and infection.
Vaginitis is diagnosed by examination from your healthcare provider. Usually a sample of the vaginal discharge is examined under a microscope. At times, a sample of the discharge is sent to the lab for additional testing.
Bacterial Vaginosis (BV) is the most common vaginal infection. BV is caused by an abnormal overgrowth of bacteria in the vagina. Range of symptoms of BV include absence of symptoms to abnormal vaginal discharge which can be thin or creamy with a white to gray color. Discharge often is described as having a fishy odor which is increased with mixture of semen during intercourse. BV is not sexually transmitted and generally there is no need to treat a woman’s male sexual partner. Female sexual partners often have BV also and should be evaluated and treated. Treatment of BV is by an antibiotic medication taken orally or inserted vaginally.
Yeast Infection (Candidasis) is caused by an overgrowth of a fungus called candida. Yeast is the second most common vaginal infection. Symptoms of yeast can include itching, burning, redness and swelling of vulvar tissue (area outside vagina). The vaginal discharge can be white and clumpy; the vagina is often sore and itchy. Yeast infection is not a sexually transmitted disease, but the sexual partner will need treatment if symptomatic. Over the counter medications are safe and often effective in treating yeast infections. Evaluation by a healthcare provider is needed if symptoms persist after an over the counter medication is used. Prescription medications for yeast include oral and vaginal preparations. Increased risk for Vaginitis is seen in diabetes, immune system compromise, with antibiotics, pregnancy, breastfeeding and menopause. Perfumed soaps, laundry detergent, fabric softeners, scented tampons and sanitary pads, and spermicides can all increase the risk of BV and yeast vaginal infections.
Trichomoniasis (Trich) is caused by the microscopic parasite Trichomonas vaginalis. It is spread through intercourse. Symptoms of Trich may include a yellow-gray or green milky discharge that can be frothy. The discharge may have a fishy odor. Vaginal burning, irritation, redness, swelling of the vulva and pain with urination are common symptoms. Some people do not experience symptoms with Trich. Trich is treated with an oral medication. Sexual partners will need treatment to prevent the infection from recurring.
Atrophic Vaginitis (AV) is not caused by an infection but can cause vaginal discharge, irritation, dryness, itching and burning. AV is caused when estrogen levels are low, such as during breastfeeding and menopause. AV is treated with estrogen which can be inserted as a vaginal cream, pill or ring. There is a new oral medication called Osphena that has been approved for the treatment of AV which is a selective estrogen receptor modulator (SERM). AV should be evaluated by a healthcare provider and to discuss treatment options. A water soluble lubricant may also be helpful during intercourse and can be purchased over the counter.
Recommendations To Decrease Vaginitis Risk
- Wash vulvar area with a gentle, unscented soap. Plain water only can also be used to clean vulvar area.
- Wear cotton panties and avoid panties at bedtime.
- Avoid tight fitting clothes and pantyhose. If you must wear pantyhose, cut out the crotch.
- Wash clothes in an unscented detergent such as All–Free or Cheer-Free. Put underwear through a second rinse cycle.
- Change out of wet work-out clothes and bathing suits ASAP.
- Always wipe from front to back with white, unscented toilet paper after using restroom.
- Avoid scented panty liners, sanitary pads and tampons.
- Avoid taking baths except with plain water – no soaps, shampoo or bubble bath in bath water.
- Avoid perfumed or flavored sprays, powder, lotions, gels, or condoms in vaginal/vulvar area.