Vaginitis

DEFINITION

Vaginitis is an inflammation of the vagina that can result in discharge, itching and pain. The cause is usually a change in the normal balance of vaginal bacteria or an infection. Vaginitis can also result from reduced estrogen levels after menopause.

The most common types of vaginitis are:

• Bacterial vaginosis, which results from overgrowth of one of several organisms normally present in your vagina
• Yeast infections, which are usually caused by a naturally occurring fungus called Candida albicans
• Trichomoniasis, which is caused by a parasite and is commonly transmitted by sexual intercourse
• Vaginal atrophy (atrophic vaginitis), which results from reduced estrogen levels after menopause

Treatment depends on the type of vaginitis you have.

CAUSES

The cause depends on the type of vaginitis you have.

Bacterial vaginosis

Bacterial vaginosis results from an overgrowth of one of several organisms normally present in your vagina. Usually, “good” bacteria (lactobacilli) outnumber “bad” bacteria (anaerobes) in your vagina. But if anaerobic bacteria become too numerous, they upset the balance, causing bacterial vaginosis. This type of vaginitis seems to be linked to sexual intercourse — especially if you have multiple sex partners or a new sex partner — but it also occurs in women who aren’t sexually active.

Yeast infections

A yeast infection occurs when there’s an overgrowth of a fungal organism — usually C. albicans — in your vagina. Besides causing most vaginal yeast infections, C. albicans also causes infections in other moist areas of your body, such as in your mouth (thrush), skin folds and nail beds. The fungus can also cause diaper rash.

Trichomoniasis

Trichomoniasis is a common sexually transmitted infection caused by a microscopic, one-celled parasite called Trichomonas vaginalis. This organism spreads during sexual intercourse with someone who already has the infection. In men, the organism usually infects the urinary tract, but often it causes no symptoms. In women, trichomoniasis typically infects the vagina, and usually it causes symptoms.

Noninfectious vaginitis

Vaginal sprays, douches, perfumed soaps, scented detergents and spermicidal products may cause an allergic reaction or irritate vulvar and vaginal tissues. Thinning of the vaginal lining — a result of decreased hormone levels following menopause or surgical removal of your ovaries — can also cause vaginal itching and burning.

SYMPTOMS

Vaginitis signs and symptoms may include:

• Change in color, odor or amount of discharge from your vagina
• Vaginal itching or irritation
• Pain during intercourse
• Painful urination
• Light vaginal bleeding or spotting

The characteristics of vaginal discharge may indicate the type of vaginitis you have. Examples include:

• Bacterial vaginosis. You may develop a grayish-white, foul-smelling discharge. The odor, often described as fish-like, may be more obvious after sexual intercourse.
• Yeast infection. The main symptom is itching, but you may have a white, thick discharge that resembles cottage cheese.
• Trichomoniasis. An infection called trichomoniasis (trik-o-moe-NIE-uh-sis) can cause a greenish yellow, sometimes frothy discharge.

When to see a doctor

See your doctor if you develop any unusual vaginal discomfort, especially if:

• You’ve never had a vaginal infection. Seeing your doctor can establish the cause and help you learn to identify the signs and symptoms.
• You’ve had vaginal infections before, but in this case, it seems different.
• You’ve had multiple sex partners or a recent new partner. You could have a sexually transmitted infection. The signs and symptoms of some sexually transmitted infections are similar to those of a yeast infection or bacterial vaginosis.
• You’ve completed a course of over-the-counter anti-yeast medication and your symptoms persist, you have a fever, or you have a particularly unpleasant vaginal odor. These are signs the infection may be from something other than yeast or from a resistant strain of yeast.

Wait-and-see approach

You probably don’t need to see your doctor every time you have vaginal irritation and discharge, particularly if:

• You’ve previously had a diagnosis of vaginal yeast infections and your signs and symptoms are the same as before
• You know the signs and symptoms of a yeast infection and you’re confident that you have a yeast infection