In this article:
- Vaginitis is the inflammation of the walls of the vagina due to an infection or irritation and can occur in women of all ages.
- The inflammation may result from infections from viruses, bacteria, and fungus, from allergic reactions to chemical irritants, or from a lack of estrogen that can happen due to certain medications or menopause.
- Vaginitis can be treated with medications, the type of which depends on the cause.
- Self-care measures, such as maintaining hygiene, avoiding the use of scented products, and practicing safe sex, can help in managing the condition.
- Pregnancy makes you prone to the complications associated with vaginitis.
- It is important to use condoms to prevent certain sexually transmitted infections.
This gynecological problem is prevalent in females of all ages, and about one-third of females experience this ailment at least once in their lifetime. However, it is most common during the reproductive period.
Vaginitis can result from an infection or disturbance in the balance of good and bad bacteria in the vagina or from a reduction in estrogen levels in the body after menopause.
Types of Vaginitis
Vaginitis can be of the following types:
- Yeast vaginitis: An overgrowth of naturally occurring candida (a kind of fungus) in the vagina causes a yeast infection. This results in redness and itching in the vaginal and vulvar areas, leading to the production of discharge that is curdy white, odorless, and thick.
- Bacterial vaginosis: It is an infection resulting from a microbial imbalance in the vagina due to the excessive growth of one or more bacteria types that are part of the vaginal microflora.
- Atrophic vaginitis: Decreased levels of female hormones during breastfeeding or after menopause cause drying and thinning of the vaginal tissues, leading to burning, pain, or irritation.
- Trichomonas vaginitis: A sexually transmitted infection (STI) caused by the parasite trichomonas can induce vaginal burning, soreness in the vulva and vagina, and a frothy, greenish-yellow discharge. It may also lead to a burning sensation while urinating.
Causes of Vaginitis
Vaginitis often results from the coexistence of multiple causative factors, including:
- Imbalance in the natural yeast or bacterial composition of the vagina
- An allergic reaction against deodorants, spermicides, etc.
- Foreign bodies such as retained tampons
- Low estrogen levels after menopause
- Normal physiologic variation
- Fluctuations in the normal vaginal environment, which may occur due to:
- Sexual activity
- Menstrual cycle
- Wet clothing
- Tight pants
- Change in the diet
- Use of certain medications
- Douching after urination
- Overuse of personal hygiene products, such as:
- Vaginal sprays
- Scented soaps
Symptoms of Vaginitis
Vaginitis may present the following symptoms:
- Inflammation in the vagina
- Redness, itching, and irritation in the vaginal area
- Gray, white, yellow, or green vaginal discharge
- Pain or bleeding during sexual intercourse
- Change in the odor of vaginal discharge
- Burning and pain during urination
- Vaginal spotting or light bleeding
Vaginitis may present with a few or all of these symptoms in some women, while others may not experience any symptoms.
Who Can Get Vaginitis?
Although vaginitis can occur at any age, it is more common among sexually active females of reproductive age. However, vaginitis may have multiple causes and can also affect sexually inactive women.
Vaginitis and its causes can be diagnosed through the following procedures:
- Physical exam: The pelvic region is evaluated for the presence of any abnormality, redness, and tenderness around the vagina and vulva.
- pH test: The pH of the vagina is determined to check the presence of an infection. A pH higher than 5 is indicative of a vaginitis infection.
- Vaginal discharge evaluation: A sample of vaginal discharge may be taken and analyzed to detect an overgrowth of bacteria or yeast or the presence of STI-causing organisms such as trichomonas.
- Vaginal culture: Vaginal fluid samples are taken for culture, which allows the detection of causative organisms. Vaginal culture is also known as a vaginal smear test or wet mount test.
- Biopsy: If the other tests suggest the absence of an infection, a biopsy of the affected area may be performed. (2)
Medical Treatment for Vaginitis
Vaginitis treatment focuses on the cause of the problem, and, therefore, the medications used vary with the type of infection:
- Bacterial vaginosis can be treated with antibiotics, which are available in the form of oral pills or topical creams and gels that are directly applied to the vagina. It is recommended to use protection or avoid having sexual intercourse during the treatment.
- Yeast infections can be managed with antifungal creams or medicines that are inserted in the vagina. If it is certain that you have a yeast infection, over-the-counter medications can be used. However, if you are experiencing the signs for the first time or are not sure about the cause of vaginitis, consult a doctor for the correct diagnosis.
- Trichomoniasis is commonly treated with oral metronidazole (Flagyl) or tinidazole. Even if only one person experiences the symptoms, both sexual partners should undergo treatment with metronidazole to prevent relapse. (3)
- Atrophic vaginitis can be alleviated by applying estrogen-containing vaginal creams, patches, and rings or taking oral tablets that contain estrogen. However, oral estrogen may not be as effective as vaginal preparations.
Note: The use of metronidazole may cause problems such as nausea, vomiting, cramps, flushing, and headaches in people who consume alcohol. Therefore, alcohol intake should be strictly avoided during treatment with metronidazole and for 2 days after the completion of the course.
Self-Care Tips to Maintain Vaginal Health
Maintaining vaginal hygiene and personal cleanliness using the following self-care tips can help in preventing vaginitis, alleviating the symptoms, and aiding recovery:
- Wipe in a front-to-back motion after defecating or emptying your bladder.
- Avoid wearing nylon underwear as it retains heat and moisture, thus promoting bacterial growth. Instead, wear 100% cotton underwear that absorbs moisture and allows good air circulation.
- Take a warm bath to alleviate the irritation in your vaginal area, and refrain from using soap.
- Resist scratching or rubbing your vaginal area as it causes discomfort and may lead to a secondary infection.
- Do not wear body-fit clothes, such as tight jeans and bodysuits, which limit air circulation and cause friction for a long time.
- Refrain from using scented products on your vagina, even if you do not have vaginitis, as they may contain chemical irritants. These products include:
- Dyed, scented, or antibacterial soaps
- Perfumed or deodorized tampons
- Feminine deodorant sprays
- Colored or perfumed toilet paper
- Alcoholic wipes
- Use protection such as condoms and diaphragms to prevent the entry of harmful bacteria into your vagina.
- Avoid taking bubble baths or using spray jets as they can disturb the balance of the vaginal microflora.
- Replace sanitary napkins and tampons frequently.
- Do not stay in wet clothing for a long time. Change into dry clothes immediately after swimming.
- Apply a cold compress on the labial area to relieve the irritation.
- Refrain from casual sex as women with multiple sexual partners have a higher chance of having bacterial vaginosis and acquiring STIs.
- Abstain from sharing your sex toys.
- Do not share medications even if you have similar symptoms as the infection or the required treatment may differ.
- Avoid using old medicine as it may have lost its efficacy and may worsen the condition.
- Identify and discontinue the use of products that may be the reason for vaginitis caused by an allergy or sensitivity.
- Do not douche. A healthy vagina has the right balance of bacteria. Douching can alter this balance and may pass the harmful bacteria into the upper genital tracts, including the uterus and fallopian tubes.
Home Remedies for Treating Vaginitis
The use of home remedies not only helps in the treatment of vaginitis but also lowers the risk of developing it. These at-home treatment methods can alleviate discomfort and also aid quick recovery.
1. Dietary Changes
Consumption of a well-balanced diet boosts immune health, therefore supporting the body to combat infections. A weak immune system cannot prevent the overgrowth of yeast.
Fresh fruits and vegetables can help improve your vaginal health as they contain vitamins and minerals, such as vitamin C, that act as immune system boosters. (4)
Probiotics refer to the beneficial bacteria that assist in fighting infections and improve the body’s microflora. They are available as capsules, pills, and various food products.
Probiotics have been used alone and along with antibiotics for the treatment of bacterial vaginosis and the prevention of relapse. However, systemic reviews of trials of probiotics for the treatment of bacterial vaginosis have not found enough evidence for or against its efficacy. (6)(7)
A review study published in 2019 evaluated multiple randomized controlled trials that investigated the effect of probiotics on vaginal microflora, bacterial vaginosis, and vulvovaginal candidiasis. The study concluded that while probiotics are being increasingly marketed for the treatment of these conditions, there is no scientific evidence for it. (8)
The trials that were conducted vary largely in terms of treatment duration and route of administration, and thus, a conclusion on the efficacy of probiotics cannot be drawn. Therefore, it is important to conduct large scale research before including probiotics in the clinical treatment of bacterial vaginosis and vulvovaginal candidiasis and in preventing preterm birth. (8)
Vaginitis During Pregnancy
The occurrence of certain types of vaginitis during pregnancy can cause complications. Bacterial vaginosis in pregnant women, for example, is known to induce early labor, resulting in preterm delivery and thus causing low birth weight and breathing problems in the babies.
However, treatment of the disease does not necessarily prevent premature birth.
Vaginitis induced by STIs may adversely affect the pregnant woman and fetus through preterm delivery, premature rupture of membranes, and postpartum uterine infection. The risk of preterm birth is increased by 42% among infected women. (9)
Trichomoniasis can be transmitted from the mother to the child during or after delivery.
Vulvovaginitis in Young Girls
Vulvovaginitis is characterized by redness and itching in the vulvar and vaginal areas and may be associated with discharge. Additionally, it may cause soreness, burning, and pain while urinating.
Pediatric vulvovaginitis may occur due to many factors. However, the low hormone levels in young girls make them more susceptible to skin irritation as their vulvar and vaginal skin is sensitive and thin in comparison to adults.
Mild vulvovaginitis is a common disease that may often reoccur in some children. Usually, no medical intervention is required, and symptoms can be alleviated with the help of simple self-care tips.
It is essential to maintain hygiene and keep the vaginal area clean and dry. Parents can guide their children in keeping the area free of moisture and heat. If irritation reappears, strict hygiene measures should be repeated.
It is common for the disease to occur several times during childhood. It usually resolves as the girl ages and does not have any chronic effect.
Sexually transmitted diseases can cause vulvovaginitis in young children and is typically a result of sexual abuse.
Chronic vaginal discharge may be related to a foreign body in the vagina or less commonly from vaginal polyps or tumors. So, when persistent discharge is observed, medical attention should be sought.
Risk Factors for Vaginitis
The following factors can increase the risk of developing vaginitis:
- Hormonal changes
- Wearing damp or tight-fitting clothes
- Poor hygiene
- Use of contraceptives
- Uncontrolled diabetes
- Use of intrauterine device (IUD)
- Physical or emotional stress
- Unprotected sexual intercourse with multiple partners
- Unhygienic utilization of sex toys
- Regular use of spermicides in large quantities
- Use of certain medications
- Frequent douching
Complications of Vaginitis
Although vaginitis is a mild disease, it can lead to certain complications if the underlying causes are left untreated:
- Vaginitis increases the chances of catching STIs. Trichomoniasis is often associated with other STDs, and therefore, patients should be tested accordingly.
- Vaginitis caused by bacterial vaginosis or trichomoniasis in pregnant females can lead to preterm labor and delivery.
- Yeast infections can lead to irritation, pain, difficulty in urinating, and increased sensitivity in the vaginal area.
- Bacterial vaginosis can be recurrent or chronic, requiring multiple treatments.
How are vaginitis and vaginosis different from each other?
Vaginosis is an infection caused by a disturbance in the vaginal microflora balance due to the overgrowth of certain bacteria, leading to an inflamed vagina.
Vaginitis, on the other hand, refers to an inflammation in the vaginal area that may result from bacterial vaginosis or other factors such as irritants, allergy, or decreased estrogen levels. Yeast infections and trichomonal infections will also present as vaginitis.
Can condoms cause vaginitis?
If a person is allergic to latex, the use of condoms can induce an allergic reaction, which leads to itchiness in the vaginal area after sexual intercourse.
However, not using protection increases the risk of developing vaginitis. The use of non-latex condoms is recommended in these patients.
Are antibiotics effective in all cases of vaginitis?
The use of antibiotics for bacterial vaginosis is only recommended if the patient is symptomatic or recurrent. Treatment of trichomonas and yeast vaginitis is recommended.
Noninfective vaginitis is treated mainly by avoiding the causative chemical or allergen. Therefore, it is recommended to visit your doctor to get evaluated for a persistent discharge.
Is tea tree oil recommended to relieve the symptoms of bacterial vaginosis?
Tea tree is an essential oil that is obtained from the leaf extracts of Melaleuca alternifolia. It has been utilized as an antiseptic agent in traditional medicine for long.
Some women use tampons soaked with tea tree oil to improve the vaginal pH. However, the efficacy or safety of such home remedies has not yet been tested in any scientific study and is not recommended.
Is boric acid helpful in treating vaginitis?
Boric acid vaginal suppositories are not shown to be effective in treating isolated or initial cases of bacterial vaginosis. However, there is a role for boric acid in recurrent bacterial vaginosis. It is also known to be helpful in some instances of resistant yeast vaginitis. (10)
Do chamomile tea bags help in treating vaginitis?
Douching using chamomile has not been shown to help with vaginitis. No studies support the benefits of chamomile for vaginitis. (11)
Is vaginitis contagious?
Trichomonas vaginitis can be easily transmitted through sexual intercourse. Having sex with infected females can cause trichomoniasis in men. However, it rarely presents any symptoms in men and is thus often left untreated.
The man can then reinfect the female partner who might have been cured. Therefore, both partners must get treated for the disease at the same time.
Occasionally, trichomoniasis may be passed through wet towels, bathing suits, or washcloths.
Bacterial vaginosis and yeast vaginitis are not spread sexually. However, some studies have reported reduced rates of recurrence with routine use of condoms. (12)
Can vaginitis occur along with a UTI?
Urinary tract infections (UTIs) usually affect the lower urinary tract (urethra and bladder) and sometimes may spread to the upper urinary tract (ureters and kidneys). The bacteria may cause cystitis when they affect the bladder.
A study conducted in 2013 showed an association between UTI and vaginitis, despite the differences in the causative organisms. (13)
In 75% of women with bacterial vaginosis, 46% with vaginal candidiasis, and 13% of women with trichomoniasis, UTIs were diagnosed. It is thus recommended to get tested for UTIs if you are suffering from vaginitis and vice-versa. (13)
When to See a Doctor
It is advised to visit a medical practitioner if you experience any symptoms. If left untreated, vaginitis can cause complications.
Note: Avoid having sex, douching, or using tampons before your appointment so that your health care provider can examine your vaginal discharge.
What you may ask your doctor:
- What is the reason for my vaginitis?
- Do I need to be tested, such as for STIs?
- Do I need medical treatment?
- When will the symptoms subside?
- Can I still have sex?
What your doctor may ask you:
- What symptoms are you experiencing?
- Since when have you been experiencing these symptoms?
- Are you pregnant?
- What is the consistency and color of your vaginal discharge?
- Does your vaginal discharge smell?
- When was your last period?
- Have you started having sexual intercourse with a new partner?
- Do you use birth control?
- Have you ever had an STD?
Vaginitis is the general term for an inflammation of the vagina caused by infection or changes in the normal vaginal flora. The clinical signs and symptoms are similar irrespective of the cause and include vaginal discharge, pruritus, burning, irritation, erythema, dyspareunia, spotting, and dysuria.
Vaginitis is often the result of infectious agents. The most common infections include bacterial vaginosis, yeast infection, and trichomoniasis, and they account for over 90% of the infections. Cervicitis, from STIs such as gonorrhea, chlamydia, and mycoplasma, can also present as vaginitis.
Vaginitis can be treated easily with medical intervention. Home remedies can be used to avoid infections or vaginosis. However, if you experience symptoms, consulting a medical provider is recommended.