The vagina is the part of the female reproductive system that connects the cervix (the entrance to the uterus) with the vulva (the folds of skin around the vaginal and urethral openings). Under normal conditions the vagina, which is self-cleaning, flushes out dead cells and secretions in the form of a discharge. The amount, color, and texture of this discharge varies according to a woman’s monthly cycle and her stage of life, but it is usually clear or milky white, and watery or slightly viscous.
Vaginitis is an inflammation of the vaginal lining and vulva that typically includes an abnormal discharge along with itching and burning of the genital area. Most often the problem is caused by an infection, but certain irritants can also trigger it, as can hormonal changes.
At some point in their lives, about one-third of women must deal with this common problem. Though usually not a threat to health, vaginitis is uncomfortable and can be painful. Repeated bouts are common.
Symptoms of Vaginitis
- The most common symptom is an abnormal vaginal discharge that varies depending upon the cause of infection.
- Bacterial vaginosis: thin, watery discharge, heavier than usual, grayish white or yellow, often with a strong fishy odor, mild burning or irritation of the vulva and vagina, often without redness or itching. (Some women with bacterial vaginosis report no signs or symptoms.)
- Yeast infection: white, thick, odorless discharge; possible itching and burning sensations as well.
- Trichomoniasis: yellow-gray or green-tinged discharge with intense unpleasant odor; vaginal and vulvar pain and itching, especially upon urination; redness and swelling of the vulva. Symptoms may be more severe just prior to and after menstruation.
What Causes Vaginitis?
Vaginitis occurs when there is a change in the balance of microorganisms that coexist in the vagina. When the balance is normal, a natural barrier against infection is maintained and organisms that may be harmful are kept in check. Sometimes these harmful organisms suddenly multiply rapidly to cause symptoms. Other times a lowered resistance to infection allows the organisms to thrive.
Three types of infection are the most common causes of vaginitis.
Bacterial (or nonspecific) vaginosis is caused by various types of bacteria that, for reasons not always clear, multiply excessively in the vagina. It’s possible that the infection—which is the most common vaginal infection in women of childbearing age—can be spread by sexual intercourse, though this hasn’t been established. But women who have never had sexual intercourse are rarely infected.
Yeast infections, also known as candidiasis, are caused by a fungus normally found in the vagina. Repeated yeast infections are more likely to occur among women who use antibiotics, since these drugs kill off bacteria that keep the yeast in check. Women with weakened immune systems and those with diabetes are also at increased risk.
Trichomoniasis is an infection by a tiny protozool organism. The infection, which typically occurs in the vagina in women, is usually passed through sexual contact. (A man can also be infected, but will seldom show symptoms. If not treated, he can infect other sexual partners.) An estimated five million cases of trichomoniasis occur each year.
In addition to infections, vaginitis can be triggered by allergic reactions to soaps, medications, perfumes, or bath oils. In some women vaginitis is caused by an allergic reaction to the latex in condoms. Douching can also cause symptoms since it disrupts the normal balance of microorganisms in the vagina. Hormonal changes during pregnancy and menopause, which affect the vagina’s balance of microorganisms, can also produce symptoms.
What If You Do Nothing?
Many cases of vaginitis will clear up without treatment. But some types of the inflammation are especially stubborn, and the symptoms are often very uncomfortable. In addition, some cases of vaginitis carry more serious risks. Both bacterial vaginosis and trichomoniasis increase a woman’s risk of acquiring HIV infection if she is exposed to HIV—and can increase a woman’s chance of transmitting HIV infection to a sex partner. Both types of infection can also cause complications in women who are pregnant.
A heavy discharge and burning pain during urination can also be a sign of gonorrhea.
Therefore, it is important to see your doctor if you notice symptoms.
Home Remedies for Vaginitis
Self-treatment for vaginitis is advisable only when you have symptoms consistent with a mild to moderate yeast infection, you have had the condition before, and it has been diagnosed previously by a physician. If this is the case, over-the-counter antifungal medications are available in the form of vaginal suppositories and creams.
Otherwise, you should consult your doctor and be diagnosed in order to match the treatment with the cause—particularly the first time you have symptoms. It’s not wise to treat vaginitis on your own until you know what the problem is. A vaginal discharge can be a symptom of a sexually transmitted disease (for example, chlamydia or gonorrhea), in which case both you and your partner will require diagnosis and treatment.
The preventive measures below will help provide relief during an infection as well as help you avoid recurrent bouts of the problem.
You can take a number of steps to decrease your likelihood of getting vaginitis. Prevention is especially important if you have suffered from repeated episodes.
- Shower or bathe daily. Use a mild, unscented soap to gently wash the vaginal area, and dry thoroughly.
- Don’t cover up with sprays, douches, or scents. The vagina cleanses itself naturally, so there is no need to clean it artificially and risk irritation. Also, covering an unpleasant odor with scented sprays or tampons is risky because the odor could signal a problem for which you should see your doctor.
- Practice careful hygiene. When you wipe yourself after a bowel movement, wipe from front to back to avoid spreading bacteria from the rectum to the vagina. Also, thoroughly clean diaphragms, cervical caps, and spermicidal applicators after each use.
- Don’t wear tight clothing—and stick to cotton. Tight pants and underpants made of nylon, silk, or certain synthetics can trap moisture in the genital area. Wear underpants and panty hose with a cotton crotch, which allows excess moisture to escape.
- Use condoms during sex if you are undergoing treatment for vaginitis. Also use condoms if you have recurrent infections or more than one sexual partner. This can help prevent infection from vaginitis as well as from gonorrhea and other sexually transmitted diseases.
- Check on antibiotic medications. If you are prescribed antibiotics for another infection, check with your doctor about reducing your risk of yeast infection.
- Complete your treatment. If you are being treated for vaginitis, it’s important that you finish taking the medication and follow any other instructions from your doctor—even if your symptoms disappear. Symptoms can abate, yet the infection can still be present, and stopping treatment may cause it to recur.
- Make sure your sexual partner sees a doctor. Both bacterial vaginosis and trichomoniasis can be passed back and forth between partners. If you have been diagnosed with either condition, your partner should be examined to avoid any recurrence.
Beyond Home Remedies: When To Call Your Doctor
Call your doctor if you experience any of the symptoms of vaginitis for the first time, or if you notice any abnormal vaginal discharge (which could be a sign of some other infection). Also, remember that the most common forms of vaginitis have overlapping symptoms. Therefore, don’t assume that symptoms similar to those you’ve had before signal a recurrence of the same ailment. What appears to be a chronic yeast infection may actually be bacterial vaginosis.
Also call your doctor if you are taking medication for vaginitis and see no improvement after three days; another medication may be more effective or you may have some other type of condition.
What Your Doctor Will Do
Your doctor will perform a pelvic examination and take a sample of vaginal discharge to test vaginal acidity and to inspect secretions under a microscope. This makes it possible to distinguish one form of vaginitis from another. If the diagnosis is unclear, a vaginal culture may be taken. This also allows your doctor to exclude other disorders, including certain cancers, that can cause an abnormal discharge.
Once the doctor has reached a diagnosis, the appropriate medication can be prescribed. Bacterial vaginosis can be treated with the prescription drug metronidazole (Flagyl); metronidazole is used against trichomoniasis as well. Your sexual partner should also be treated if you have trichomoniasis.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media