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Vaginitis

Vaginitis

Alternate Names

  • vulvovaginitis
  • vaginal infection
  • vaginal inflammation
  • Female pelvic organs

Definition

Vaginitis is an inflammation or infection of a woman's vagina. It can be caused by bacteria, fungi, , parasites, hormonal changes, or chemicals.

What is going on in the body?

A healthy vagina has a balance of many normal chemicals, bacteria and fungi. Normal vaginal discharge is clear, cloudy, or whitish.
But the balance in the vaginal environment can be thrown off by many factors. Following are some of the common factors affecting the balance:
  • change in hormone levels
  • impaired health
  • normal aging
  • sexual activity
  • stress
  • certain medications

Risks

What are the causes and risks of the condition?

Vaginal yeast infections are one of the most common causes of vaginitis. They are usually caused by an overgrowth of Candida albicans, or other less common species. . This type of infection often produces a thick, whitish vaginal discharge that may look like cottage cheese and vulvar and vaginal burning and itching.
Yeast infections are often seen after the woman has taken antibiotics for another infection. The antibiotics interfere with the normal balance of organisms in the vagina.
Bacterial vaginosis occurs when several types of harmful bacteria that live in the vagina grow too fast. No one knows what causes the overgrowth of these bacteria. The harmful bacteria can replace protective bacteria. This makes the vagina less acidic.
Half of the time, vaginosis causes no symptoms. Some women may have a grayish-white or yellowish-white discharge as well as vaginal discomfort and a fishy odor.
Trichomoniasis is caused by a parasite. It spreads during sexual activity. There is a large amount of frothy vaginal discharge. The discharge is usually yellow-gray or green and has an unpleasant odor.
Atrophic vaginitis is associated with low levels of estrogen. The vagina becomes less acidic at times and the lack of estrogen allows the vaginal lining to become very thin and easily irritated. Some women with this condition have no symptoms. Others have vaginal dryness and burning. Usually this condition occurs after menopause. Sometimes it affects nursing mothers or girls before they reach puberty.
Non-infectious causes of vaginal irritation include:
  • chemicals in deodorants, powders, or soaps
  • chemicals in spermicides, condoms, and diaphragms
  • douches
  • an object left in the vagina, such as a forgotten tampon
  • sex toys
  • sexual intercourse

Other factors that increase a woman's risk for vaginitis include the following:
  • breastfeeding
  • underclothing that holds heat and moisture, such as nylon panties
  • diabetes
  • immunodeficiency disorders, which weaken her response to infection
  • poor hygiene
  • pregnancy

Prevention

What can be done to prevent the condition?

Vaginitis cannot always be prevented. Following these recommendations can lower a woman's risk for vaginitis.
  • Avoid douches and other chemicals in the vaginal area.
  • Consider hormone replacement therapy after menopause.
  • Control blood glucose, if she has diabetes.
  • Condom use may decrease the risk of trichomoniasis
  • Wear loose-fitting, absorbent underwear.
  • Wipe front to back after using the toilet.

Diagnosed

How is the condition diagnosed?

The diagnosis of vaginitis begins with a medical history and physical exam. The healthcare provider will do a pelvic exam. The provider may also take the following steps.
  • Check the acidity of the vaginal discharge.
  • Order tests to rule out STIs or other diseases.
  • Perform a Pap test.
  • Take a sample of discharge from the vagina to look at under the microscope or to send to a lab for analysis

Long Term Effects

What are the long-term effects of the condition?

If an infection is treated, long-term problems usually do not arise. Sometimes the cause of vaginitis cannot be cured. Severe STDs may cause chronic pain and infertility.

Other Risks

What are the risks to others?

If the vaginitis is caused by a STI, a woman can transmit the infection to a sexual partner.

Treatments

What are the treatments for the condition?

Treatment options depend upon the cause of vaginitis. Therapy may include the following:
  • antibiotic medicines such as metronidazole (i.e., Flagyl) or clindamycin (i.e., Cleocin)
  • antifungal medicines, such as nystatin (i.e., Mycostatin, Nilstat), miconazole (i.e., Micatin, Monistat), clotrimazole (i.e., Mycelex), fluconazole (i.e., Diflucan), terconazole (i.e., Terazol) or butaconazole (i.e., Gynazole, Mycelex)
  • hormone therapy
  • sitz baths, which involve sitting in a few inches of warm water
  • soothing vaginal creams or ointments

Side Effects

What are the side effects of the treatments?

Antibiotics and antifungal medicines may cause rash, stomach upset, or allergic reactions.

After Treatment

What happens after treatment for the condition?

Vaginitis may take a few days or more to disappear, depending on how long an infection has been present and the cause of the inflammation. If an STD has been diagnosed, the sexual partner or partners should be tested.

Monitor

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

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