Most women will experience a vaginal infection at least once in their lives. In the United States, women seek medical help for these infections 10 million times a year. Vaginitis is an extremely common disease, but it is not necessarily a serious one. There are many possible causes, and the type of treatment depends upon the cause.

What is Vaginitis?

Very simply, vaginitis is an infection within the vagina that may cause symptoms of itching or burning on the vulva. A healthy vagina has a normal discharge - fluid that passes out of the vagina - that is clear or cloudy, has a mild odor, and doesn't itch or burn. A healthy vagina keeps a balance of many organisms, such as bacteria and yeast.  When your vagina is healthy, it is protected from infection by "friendly" bacteria and varying amounts of discharge. If this normal environment changes, or if "unfriendly" bacteria enter your vagina, infection can turn a healthy scene into an unhealthy one. When your vagina becomes infected, the discharge often increases and thickens, has an unpleasant odor, and causes itching, burning, and swelling.

Many factors can influence the normal balance of the vagina, such as:

  • Antibiotics
  • Changes in the body's normal hormone levels, such as those that occur with pregnancy, breast feeding, or menopause
  • Douching, vaginal deodorant sprays, or soaps
  • Spermicides 
  • Sexual Intercourse
  • Sexually Transmitted Diseases
  • Irritation
  • Foreign objects, such as tampons

A change in the normal balance can allow either yeast or bacteria to increase and result in vaginitis

Symptoms

Every woman has her own pattern of normal vaginal secretions. Learning to recognize your pattern will enable you to more easily notice any change that might be a symptom of vaginitis. Although vaginitis is nothing more than a painful nuisance, you must never put off seeing a physician if you have any symptoms. An accurate diagnosis must be made to rule out the possibility of a more serious threat to your health, such as gonorrhea. Specific symptoms are listed in the section "Types of Vaginitis" below.

Testing and Diagnosis

During your exam, the physician will review your medical history and ask about any recent changes in your lifestyle or activities. A pelvic exam will be done to examine your vagina and other reproductive organs, and to collect a sample of vaginal discharge. The physician will study this sample under a microscope to determine what organism is causing your problem. To ensure an accurate diagnosis, you should not be examined while you are on your period.  Also, don't use douches, vaginal medications, or sprays during the two days before your exam. 

Types of Vaginitis

Three major types of vaginitis affect women:

  1. Yeast (Candida, Monilia) 
  2. Trichomonas
  3. Bacterial Vaginosis

Yeast (Candida, Monilia) 

A yeast infection is an overgrowth of yeast fungus due to changes in hormone levels or blood sugar, or lowered resistance to infection. It often occurs with pregnancy, diabetes, high stress, or use of antibiotics or birth control pills. The symptoms include:

  • Vaginal itching or burning (the burning may be worse with urination or sex)
  • White clumpy discharge (resembling cottage cheese)
  • Slight odor (similar to baking bread)
  • Discomfort during or after intercourse

Treatment may include vaginal cream, or suppositories, or "over the counter" non-prescription medications. (Please review the "Self-Care for Yeast Infections" section below.

Trichomonas

Trichomonas, or "Trich",  is a one celled parasite that can cause an infection called trichomoniasis. (Don't confuse this condition with trichinosis, which is produced by roundworms found in undercooked pork!) "Trich" is often passed from one person to another through sexual intercourse. The symptoms include:

  • Intense vaginal itching, burning, or swelling
  • Foamy gray or yellow-green discharge
  • Unpleasant "fishy" or "musty" odor
  • Pain during urination or sexual intercourse

Treatment requires prescription oral antibiotics. The length of treatment varies, but most cases can be treated with a single dose of medication. Your partner may need treatment, too, although men usually don't have symptoms. You both must complete the treatment to avoid reinfecting each other.

Bacterial Vaginosis

The bacteria that cause bacterial vaginosis occur naturally in the vagina. It is the overgrowth of several of these bacteria that cause an infection to occur. These infections can arise for unknown reasons, and may be passed on sexually. The symptoms include:

  • Vaginal itching, burning, swelling
  • Watery gray discharge
  • Unpleasant "fishy" odor
  • Pain during urination or sexual intercourse

Treatment requires prescription oral antibiotics or other medication. Your partner must be treated at the same time, and you both must complete the full course of treatment to prevent reinfection.

Self-Care for Yeast Infections

Most drugstores now carry creams, tablet, and suppositories that let you treat yeast infections without a prescription. But don't use these medications unless you've had a yeast infection diagnosed in the past and you are absolutely sure you have one again. Please call our office and discuss your symptoms with our triage nurse. She'll advise you whether you should come in for an exam. If you do buy over-the-counter non-prescription medication, follow these suggestions:

  • Read all instructions and use the medication for the full course of treatment, even if your symptoms disappear within a few days.
  • Ask your pharmacist any questions you may have about these medications.
  • Be sure to contact our office if your symptoms do not clear up with self-treatment; you may have something other than a yeast infection.

Prevention

Preventing vaginitis may be as simple as changing a few habits related to your hygiene, clothing, or lifestyle.

  • Use mild, unscented soap when you bathe or shower to avoid irritating your vagina.
  • Wash your vulva (outer vaginal area) thoroughly every day and keep it as dry as possible to guard against bacterial growth.
  • Wipe from front to back after a bowel movement. This prevents spreading bacteria from your anus to your vagina.
  • Avoid using douches (unless recommended by your health care provider), vaginal sprays, scented toilet paper, or scented tampons. They contain chemicals that can irritate your vagina.
  • Change tampons frequently during your period to allow the flow of normal vaginal discharge.
  • Clean your diaphragm and spermicide applicators thoroughly to avoid the transfer of bacteria.
  • Don't sit around in wet clothes, since yeast thrive in a warm, damp environment.
  • Avoid wearing tight pants or pantyhose without a cotton crotch, since they trap warmth and moisture.
  • Wear cotton underwear to allow good circulation around your vagina.
  • Eat a variety of healthy foods. Too many sweet or starchy foods in your diet may speed up the growth of harmful bacteria.
  • Limit your number of sexual partners and use latex condoms to reduce your risk of infection.
  • Lose weight if you are heavy. Obesity can promote infection by preventing air circulation around your vagina.
  • Get enough rest and sleep to keep your resistance high.
  • Control your stress level to help your body fight infection.
  • Exercise regularly to reduce your stress and strengthen your body's resistance to infection.
  • Help your partner understand his role in preventing vaginal problems and completing any treatment.