Symptoms And Treatments Of Vaginitis
"Vaginitis" is a word that is used to described disorders that cause infection or
inflammation ("itis" means inflammation) of the vagina. Vulvovaginitis refers to
inflammation of both the vagina and vulva (the external female genitals). These conditions
can result from an infection caused by organisms such as bacteria, yeast, or viruses, as
well as by irritations from chemicals in creams, sprays, or even clothing that are in
contact with this area. In some cases, vaginitis results from organisms that are passed
between sexual partners.
Vaginitis can sometimes be a sign of other health problems. Knowing more about the
signs and symptoms of this common condition will help you and your health care provider
make a proper diagnosis.
The common symptoms of vaginitis are itching, burning, and vaginal discharge that is
different from your normal secretions. The itching and burning can be inside the vagina
or on the skin or vulva just outside the vagina. Discomfort during urination or sexual
intercourse may also occur. If everyone with vaginitis had these symptoms, then the
diagnosis would be fairly simple. However, it is important to realize that as many as 4
out of every 10 women with vaginitis may not have these typical symptoms. Frequently, a
routine gynecologic exam will confirm vaginitis even if symptoms are not present. This is
one reason why it is important to have a gynecologic exam at least every 2 years.
A women's vagina normally produces a discharge that is usually described as clear or
slightly cloudy, non-irritating, and odor-free. During the normal menstrual cycle the
amount and consistency of discharge vary. At one time of the month there may be a small
amount of a very thin or watery discharge and at another time, a more extensive thicker
discharge may appear. All of these descriptions could be considered normal.
A vaginal discharge that has an odor or that is irritating is usually an abnormal
discharge. The irritation might be itching or burning or both. The burning could feel like
a bladder infection. The itching may be present at any time of the day but it is often
most bothersome at night. Both of these symptoms are usually made worse by sexual
intercourse. It is important to see a doctor or clinician if there has been a change in
the amount, appearance, or smell of the discharge.
Yeast infections of the vagina are what most women think of when they hear the term
"vaginitis." They are caused by one of the many species of fungus called Candida. Candida
normally live in small numbers in the vagina as well as in the mouth and digestive tract
of both men and women.
Yeast infections produce a thick, white vaginal discharge with the consistency of
cottage cheese. Although the discharge can be somewhat watery, it is odorless. Yeast
infections usually cause the vagina and the vulva to be very itchy and red.
Since yeast is normal in a women's vagina, what makes it cause an infection? Usually
this happens when a change in the delicate balance in a woman's system occurs. For example,
a woman may take an antibiotic to treat a urinary tract infection and the antibiotic
kills her "friendly" bacteria that normally keep the yeast in balance; as a result the
yeast overgrows and causes the infection. Other factors which can upset the delicate
balance include pregnancy which changes hormone levels and diabetes which allows too much
sugar in the urine and vagina.
Although "yeast" is the name most women know, bacterial vaginosis is actually the most
common vaginal infection in women of reproductive age. Bacterial vaginosis will often
cause a vaginal discharge. The discharge is usually thin and milky and is described as
having a "fishy" odor. This odor may become more noticeable after intercourse. Redness or
itching of the vagina are not common symptoms of bacterial vaginosis. It is important to
note that many women with bacterial vaginosis have no symptoms at all and the vaginitis is
only discovered during a routine gynecologic exam. Bacterial vaginosis is caused by a
combination of several bacteria. These bacteria seem to overgrow much the same way as
Candida will when the vaginal balance is upset. The exact reason for this overgrowth is
not known. Since bacterial vaginosis is caused by bacteria, not by yeast, it is easy to
see that different methods are needed to treat the different infections. A medicine that
is appropriate for yeast is not effective against the b
acteria that causes bacterial vaginosis.
Trichomonias, commonly called "trite" (pronounced "trick"), is caused by a tiny
single-celled organism known as a "protozoa." When this organism infects the vagina
is can cause a frothy, greenish-yellow discharge. Often this discharge will have a foul
smell. Women with trichomonal vaginitis may complain of itching and soreness of the vagina
and vulva, as well as burning during urination. In addition, there can be discomfort in
the lower abdomen and vaginal pain with intercourse. These symptoms may be worse after the
menstrual period. Many women, however, do not develop any symptoms. It is important to
understand that this type of vaginitis can be transmitted through sexual intercourse. For
treatment to be effective, the sexual partner must be treated at the same time as the
patient.
Another primarily sexually transmitted form of vaginitis is caused by the germ known as
Chlamydia. Unfortunately, most women do not have symptoms. This makes diagnosis difficult.
A vaginal discharge is sometimes present with this infection but not always. More often a
woman might experience light bleeding especially after intercourse. She may have pain in
the lower abdomen and pelvis. Chlamydial vaginitis is most common in young women (18 to 35
years) who have multiple sexual partners. If you fit this description, you should request
screening for Chlamydia during your annual checkup. The best "treatment" for Chlamydia is
prevention. Use of a condom will decrease your risk of contracting not only Chlamydia, but
other sexually transmitted diseases as well.
Viruses are a common cause of vaginitis. One form caused by the herpes simplex virus
(HSV) is often just called "herpes" infection. These infections are also spread by sexual
intimacy. The primary symptom of herpes vaginitis is pain associated with lesions or
"sores." These sores are usually visible on the vulva or the vagina but occasionally are
inside the vagina and can only be seen during a gynecologic exam. Outbreaks of HSV are
often associated with stress or emotional upheaval.
Another source of viral vaginal infection is the human papillomavirus (HPV). HPV can
also be transmitted by sexual intercourse. This virus can cause painful warts to grow in
the vagina, rectum, vulva, or groin. These warts are usually white to gray in color, but
they may be pink or purple. However, visible warts are not always
present and the virus may only be detected when a Pap smear is abnormal.
Occasionally, a woman can have itching, burning, and even a vaginal discharge without
having an infection. The most common cause is an allergic reaction or irritation from
vaginal sprays, douches, or spermicidal products. The skin around the vagina can also be
sensitive to perfumed soaps, detergents, and fabric softeners.
Another noninfectious form of vaginitis results from a decrease in hormones because of
menopause or because of surgery that removes the ovaries. In this form, the vagina becomes
dry or "atrophic." The woman may notice pain, especially with sexual intercourse, as well
as vaginal itching and burning.
The key to proper treatment of vaginitis is proper diagnosis. This is not always easy
since the same symptoms can exist in different forms of vaginitis. You can greatly assist
your health care practitioner by paying close attention to exactly which symptoms you have
and when they occur, along with a description of the color,
consistency, amount, and smell of any abnormal discharge. Do not douche before your office
or clinic visit; it will make accurate testing difficult or impossible.
Because different types of vaginitis have different causes, the treatment needs to be
specific to the type of vaginitis present. When a woman has had a yeast infection
diagnosed by her doctor, she is usually treated with a prescription for a vaginal cream or
suppositories. If the infection clears up for some period of time but then the exact same
symptoms occur again, a woman can obtain, with her doctor or pharmacist's advice, a
vaginal cream or suppository without a prescription that can completely treat the
infection. The important thing to understand is that this medication may only cure the
most common types of Candida associated with vaginal
yeast infections and will not cure other yeast infections or any other type of vaginitis.
If you are not absolutely sure, see your doctor. You may save the expense of buying the
wrong medication and avoid delay in treating your type of vaginitis.
Other forms of infectious vaginitis are caused by organisms that need to be treated
with oral medication and/or a vaginal cream prescribed by your doctor. Products available
without a prescription will probably not be effective. As with all medicine, it is
important to follow your doctor's instructions as well as the instructions that come with
the medication. Do not stop taking the medicine when your symptoms go away. Do not stop
taking the medicine when your symptoms go away. Do not be embarrassed to ask your doctor
or health care practitioner questions. Good questions to ask include: It is okay to douche
while on this vaginal cream? Should
you abstain from sexual intercourse during treatment? Should your sexual partner(s) be
treated at the same time? Will the medication for this vaginitis agree with your other
medication(s)? Should you continue the vaginal cream or suppositories during your period?
Do you need to be reexamined and if so, when?
"Noninfectious" vaginitis is treated by changing the probable cause. If you have
recently changed your soap or laundry detergent or have added a fabric softener, you might
consider stopping the new product to see if the symptoms remain. The same instruction
would apply to a new vaginal spray, douche, sanitary napkin, or
tampon. If the vaginitis is due to hormonal changes, estrogen may be prescribed to help
reduce symptoms.
There are certain things that you can do to decrease the chance of getting vaginitis.
If you suffer from yeast infections, it is usually helpful to avoid garments that hold in
heat and moisture. The wearing of nylon panties, pantyhose without a cotton panel, and
tight jeans can lead to yeast infections. Good hygiene is also important. Many doctors
have found that if a woman eats yogurt that contains active cultures (read the label) she
will get fewer infections.
Because they can cause vaginal irritation, most doctors do not recommend vaginal sprays
or heavily perfumed soaps for cleansing this area. Likewise, repeated douching may cause
irritation or, more importantly, may hide a vaginal infection.
Safe sexual practices can help prevent the passing of diseases between partners. The
use of condoms is particularly important.
If you are approaching menopause, have had your ovaries removed, or have low levels of
estrogen for any reason, discuss with your doctor the use of hormone pills or creams to
keep the vagina lubricated and healthy.
See also: Candidiasis.html">Candidiasis