Vaginitis is one of the most common reasons women seek health care. It affects
all women - lesbian, straight, and bisexual - regardless of sexual orientation.
You will most likely have it some time in your life. You may have it more than
once. It usually is not serious. But it can be annoying and uncomfortable.
You will have a vaginal irritation or an abnormal vaginal discharge. The discharge
may have an unpleasant odor. You also may have vaginal itching or burning. And
you may feel as if you need to urinate more often than usual.
Vaginitis is caused by
infections
lack of the hormone estrogen
irritants - including douches, "feminine hygiene" sprays, and perfumed
soaps
allergies
sexual activity
And sometimes there is more than one cause.
Questions About Vaginal Fluids
They are either thick and whitish or slippery and clear. It depends on where
you are in your menstrual cycle. There is little odor and no itching or burning.
Regular bathing keeps the fluids from getting stale or uncomfortable.
The fluids come from the walls of your vagina. They also come from your cervix at certain times in your cycle. They leave the body through the vagina.
How much fluid you produce depends on the hormones that guide your menstrual cycle. Usually there is more fluid
just before you ovulate
when you are pregnant
when you are sexually excited
You will have less fluid just before your period, while you breast-feed, and
during menopause.
Questions About the Types of Vaginitis
They are
candidiasis (can-di-DYE-a-sis)
bacterial vaginosis (back-TEER-ee-al VA-ji-NO-sis)
trichomoniasis (trick-oh-mo-NEYE-ah-sis)
What is candidiasis?
Candidiasis is an infection caused by a yeast called candida (CAN-di-duh). It
is also called monilial (mon-EEL-ee-al) vaginitis. Most people have small amounts
of yeast in their mouths and intestines. Many healthy women have yeast in their
vaginas. But sometimes this yeast grows too much. "Overgrowth" may
happen when the normal condition of the vagina is changed by
certain antibiotics
pregnancy
diabetes
immune deficiency
drugs that slow the immune system (like cortisone)
normal hormonal changes (some women)
Symptoms include
a thick, white, odorless, vaginal discharge
a white coating of the vagina
itching, irritation, and redness of the vulva and opening of the vagina
Men with yeast infections may notice redness and irritation of the penis or
scrotum.
When excess yeast appears in the mouth, throat, or tongue, it is called "thrush."
Diagnosis is made by examination of the vagina and vaginal discharge. Various creams, suppositories, vaginal tablets, as well as oral medication can be used to treat candidiasis. Treatment is successful more than 90 percent of the time.
BV is a condition caused by several bacteria, including gardnerella (gard?ner?EL?la)
vaginalis. BV used to be called "nonspecific vaginitis."
Usually there is a heavy vaginal discharge. It is grayish and frothy and has an unpleasant, "fishy" odor.
BV is sometimes caused or made worse by unprotected sexual contact that can disrupt the balance of normal bacteria that protect the vagina. Certain body fluids, especially semen, may be more disruptive for some women.
Diagnosis is made by examination of the vagina and vaginal discharge. Various creams and gels, as well as oral medication, can be used to treat BV.
Trichomoniasis is a sexually transmitted infection. "Trich" is one
of the most common vaginal infections. It is spread by exchanging fluids through
vaginal intercourse
sharing sex toys
mutual masturbation, if fluids from one partner are passed to the genitals of
the other
Many women have no symptoms. Men rarely have symptoms. It may take years for
them to appear. Symptoms include
a frothy, often musty smelling discharge
itching in and around the vagina
an urge to urinate more often than usual
spotty bleeding in the discharge
Diagnosis is made by examination of the vagina and vaginal discharge. Both partners
can be successfully treated for "trich" with oral medication. You
may become infected again if your partner isn't treated. If you have more than
one sexual partner, each partner (and their partners) should be treated, too.
Use condoms with your partner(s) during treatment.
What is atrophic vaginitis?
Atrophic vaginitis is a vaginal irritation without a discharge. It is caused
by lowered levels of estrogen due to
breast-feeding
natural menopause
induced menopause - when both ovaries are removed surgically or damaged by radiation
or chemotherapy
Lowered levels of estrogen make vaginal tissue dry and thin. They may also cause
spotting. Estrogen creams and oral tablets can help
restore lubrication
decrease soreness and irritation
What irritants can cause vaginitis?
Objects and chemicals left in the vagina may cause irritations that lead to
vaginitis. Do not leave tampons, toilet tissue, contraceptives, or other objects
in the vagina longer than necessary.
What can stimulate allergies that can cause vaginitis? Some women are allergic
to substances put in the vagina, including
medicines
latex condoms
diaphragms and cervical caps
spermicides
chemicals - including douches, "feminine hygiene" sprays, and perfumed
soaps
Questions About Irritations of the Cervix and Vulva
What is cervicitis?
It is an irritation of the cervix. There may be an abnormal discharge from the
cervix. It can look and feel just like a vaginal discharge. That's why cervicitis
is often confused with vaginitis. Serious cases of cervicitis are caused by
infections such as gonorrhea, chlamydia, or herpes. It's very important to diagnose
and treat cervicitis.
It is an irritation of the vulva - a woman's external sex organs that are outside
the vagina, including the clitoris, the labia (lips), and the glands that lubricate
the vagina. It may result from a yeast infection or the discharge associated
with vaginitis.
The vulva and vagina may also be irritated by
scented or colored toilet paper
perfumed soaps or bubble baths
shampoos and hair conditioners
laundry detergents (especially enzyme-activated "cold-water" formulas)
"feminine hygiene" sprays
spermicides
douches
hot tub and swimming pool water
wearing tight pants, underwear, or pantyhose without a cotton crotch
wearing wet bathing suits for long periods of time
rubbing against a bicycle seat
horseback riding
tampons or other objects left in the vagina too long
Questions About Reducing the Risk of Getting Vaginitis
Can I get vaginitis from a sex partner?
"Trich" is easily passed between sex partners - same sex as well as
opposite sex partners. Men can carry trichomonas, the protozoan that cause trichomoniasis,
on the penis, under the foreskin, and in the urethra, prostate gland, and other
glands.
It is not yet clear if BV and candida infections are transmitted from one partner to another. All kinds of bacteria are exchanged during sexual intercourse. It may be that the bacteria exchanged between partners, especially new partners, may cause an overgrowth of BV or candida in the vagina.
How can I recognize and avoid vaginitis?
Each woman has her own pattern of vaginal fluids. Learn your own normal pattern.
Then you will notice any changes that may mean you have vaginitis.
Avoid sexual intercourse if
you or your partner is being treated for a sexually transmitted infection
you think either of you is infected
condoms or female condoms are unavailable
Because yeast, BV, and "trich" develop more quickly in moisture
Keep the area around the genitals as dry as possible.
Wear underwear and panty hose with cotton crotches.
Avoid wearing jeans, pants, panty girdles, or pantyhose that are too tight.
Wash your vulva regularly with mild soap and water.
Rinse well and dry thoroughly after washing.
Don't share towels.
Let towels dry between uses.
Avoid sitting around in a wet bathing suit.
And try to
Avoid chemicals in perfumed or deodorant soap, detergents, fabric softeners,
bubble baths, powder, and vaginal sprays. Don't douche unless your clinician
advises.
Always wipe away from the vagina - front to back - after bowel movements.
Inspect your partner's sex organs for sores or discharges.
Use a latex condom every time you have vaginal intercourse, unless you and your
partner
have no infections
have no other sex partners
Questions About the Diagnosis and Treatment of Vaginitis
Don't douche for at least 24 hours before your appointment. Douching washes
away the discharge and may make the tests less accurate.
Don't use a deodorant on your vulva. It may mask odors that are important symptoms.
And it may make an irritation worse.
Don't put off going because you have abnormal bleeding. That might mean you
have a serious problem.
Don't have vaginal intercourse - or insert any object, such as a tampon, into
your vagina - for 24 to 48 hours before your appointment.
Try to schedule your visit after your period. Menstrual flow makes diagnosis
more difficult.
How is vaginitis treated?
Treatment depends on
the cause
how severe your symptoms are
whether you are pregnant
For vaginitis caused by infection, your clinician may prescribe creams, suppositories,
vaginal tablets, or oral medications.
For vaginitis caused by low levels of estrogen, symptoms are usually relieved by replacing the estrogen with estrogen replacement creams and vaginal rings. They are available by prescription.
For vaginitis caused by an irritant left in the vagina, symptoms are usually relieved by removing the object. Using an antibiotic cream is necessary in some cases.
For vaginitis caused by allergies, common symptoms are usually relieved by avoiding contact with the substance stimulating the allergy. Severe reactions may require emergency medical attention.
For any type of vaginitis, allowing the vagina to heal during treatment is important, so avoid intercourse until the infection is gone.
Remember - Vaginitis has little to do with how clean you are. Bathing or douching will not cure vaginitis. But good hygiene is an important part of being healthy. It includes washing your vulva daily with mild, perfume-free cleansers,
You can buy medicine for yeast infections without a prescription. This will
help if you are sure you have a yeast infection. Your symptoms should be the
same as those your clinician diagnosed before. Also be sure you haven't been
exposed to a sexually transmitted infection since your last treatment for yeast.
What you think is yeast could be "trich," herpes, or gonorrhea. Consult
your clinician if you
have an unusual symptom
are not better when you've finished the medicine
Should I use tampons while I'm being treated?
You may have to apply medicine to your vagina or vulva. Tampons will soak up
the medicine. They may also irritate your vagina. A sanitary napkin or mini-pad
may help keep the medicine from leaking onto your clothing. Ask your clinician
for advice.
It is better not to. Intercourse may be uncomfortable or painful. It may also
aggravate your symptoms and interfere with the effectiveness of treatment. If
you and your partner are being treated for trichomoniasis, gonorrhea, or chlamydia,
you may re-infect one another. If you do decide to have intercourse during treatment,
be sure to use condoms or female condoms.
Don't use anybody else's medicine. Your symptoms may be like somebody else's.
However, the cause of your symptoms may be different and need different treatment.
Don't use old medicine. It may not work anymore and it may cause problems.
Use up your entire prescription - even if your symptoms have stopped. They may
come back if you don't take all your medicine.
Take your medicine even if you get your period. Some organisms that cause vaginitis
grow quickly in menstrual flow.
Be sure to return for all your checkups.
Your partner should also be treated if you are being treated for
vaginitis caused by trichomoniasis
cervicitis caused by chlamydia or gonorrhea
Do I need to see a clinician?
Yes. It is very important if you think you have vaginitis. Vaginitis isn't often
a major health problem. But the cause may be very serious. Serious infections
like gonorrhea and chlamydia have symptoms just like vaginitis. Your clinician
can find the cause and offer the correct treatment.
You should see your clinician whenever you have abnormal vaginal discharge
and/or odor, irritation, bleeding, or pain your symptoms have not been diagnosed
your treatment isn't working
What is recurrent vaginitis?
Vaginitis is called "recurrent" if you have it three or more times
a year. It can be caused by incomplete treatment of previous infections
repeated new infections or irritation conditions like diabetes or HIV (human
immunodeficiency virus) that weaken the immune system It may be hard to find
the cause and clear it up. Having recurrent vaginitis can be very frustrating.
See your clinician regularly if you have it.
Written by Jon Knowles
Revised by Danielle Dimitrov