Vaginitis

Overview

Vaginitis is a condition characterized by an inflammation or infection of vagina caused by organisms (viruses, bacteria, or yeast) and other chemical irritants.  Women with vaginitis may experience burning, itching, bad odor or abnormal vaginal discharge.

The vagina has bacteria and yeast that contributes to its normal function. Imbalance or shift on the ratio of the bacteria and yeast can cause vaginitis. It can also be brought on by some infections, skin conditions, vaginal dryness and decreased estrogen levels following menopause. The treatment for vaginitis depends on the underlying cause of the condition.

There are several types of vaginitis, the most common are:

• Bacterial vaginosis: This is a vaginal infection caused by the bacterial imbalance or overgrowth in the vagina, which may have symptoms of vaginal discharge and fishy odor.
• Yeast infections: These are typically brought on by Candida albicans, a fungus naturally found in the body which occurs if the yeast develops quickly and is out of balance which causes a yeast infection.
• Trichomoniasis: This is an infection caused by a parasite transmitted during sexual intercourse and is a common sexually transmitted disease (STD) and has usually no noticeable symptoms.
• Chlamydia and Gonorrhea: These are common sexually transmitted infections caused by bacteria and are usually asymptomatic.
• Viral vaginitis: This is a skin infection caused by herpes simplex virus (HSV) or human papillomavirus (HPV), commonly transmitted through sexual contact.

Symptoms

Each type of vaginitis may have different signs and symptoms.  Generally, most may experience:

• Vaginal discharge changes in color, thickness, and smell
• Vaginal burning or itching
• Soreness or irritation around or outside the vagina
• Painful urination
• Painful sex
• Light vaginal spotting or bleeding

In most cases, the vaginal discharge can help with diagnosis of vaginitis as the discharge changes depending on the underlying cause of the infection. For instance:

• Bacterial vaginosis: Increased discharge with a distinct fishy odor is the major symptom. The smell could be more obvious after having sex or during menstruation. The discharge is typically thin, grayish-white, or dull gray.
• Yeast infection: The discharge is watery and has no odor. It can be white, lumpy, or thick and is almost cottage-cheese-like. There may be an increase in vaginal discharge.
• Trichomoniasis: The vaginal discharge is foamy, greenish-yellow, or yellow-gray color and has a foul smell.

Women who notice changes or experience discomfort in the vaginal area should visit their Obstetrician–Gynecologists for assessment. It highly recommended for those who have:

• Increased vaginal discharge with foul-smelling odor
• Itching and irritation in vaginal area
• History of vaginal infections
• Unresponsive to over-the-counter medications
• New or several sexual partners that can contribute to higher risk for sexually transmitted infection
• Fever or pelvic pain

Women with vaginitis need to monitor the changes in symptoms. It is possible to have more than one type of vaginitis at the same time.

However, it may not be necessary to constantly visit a healthcare provider every time a vaginitis symptom occur especially if the signs and symptoms remain the same since the previous diagnosis of vaginal yeast infection.

Causes

The different types of vaginitis have varying causes:

• Bacterial vaginosis: Resulted from the imbalance of normal bacteria in the vagina. It is a common infection among women of reproductive age but is often left untreated due to lack of symptoms. It is not a sexually transmitted infection (STI) and can happen to women who are not sexually active.  Women who douche, smoke cigarettes or has new or multiple sex partners have higher risk for this type of infection.
• Yeast infections: Also known as candidiasis and is one of the most common vaginitis which occurs from imbalance of bacteria and yeast in the vagina which leads to the overgrowth of fungus, usually Candida albicans. The same fungus can also cause diaper rash.  The infection can occur in moist parts of the body such as mouth, skin creases and nail beds.
• Trichomoniasis: A protozoa known as Trichomonas vaginalis causes this type of vaginitis. This infection is a common non-viral sexually transmitted disease (STD). Having this condition also raises a person’s chance of contracting other STDs.

Since the infection spreads through direct sexual contact, both genders are at risk. However, women are more susceptible to experiencing symptoms. The organism typically affects the urinary tract in men and the vagina in women.

• Noninfectious vaginitis: This refers to allergic reaction or irritation caused by different products that are too strong for the vaginal tissues and vulva. The potential irritants include foreign materials (e.g., tampons and toilet paper), sprays, douches, scented soaps, scented detergents, spermicidal treatments, feminine products and wipes, sexual lubricants, among others.
• Genitourinary syndrome of menopause (atrophic vaginitis): Is a non-infectious type of vaginitis caused by a drop in hormone level, particularly estrogen which causes the thinning of the vaginal lining, producing symptoms as burning, dryness and vaginal irritation during the post menopause or surgical ovarian removal.

Risk factors

Several factors can alter the normal state of the vagina that raises one’s risk of getting vaginitis, such as:

• Recent course of antibiotics and steroids
• Changes in hormone levels due to pregnancy, breastfeeding, menopause, and birth control
• Existing sexually transmitted infection
• Vaginal douching
• Sexual intercourse
• Use of intrauterine device (IUD) and spermicides for birth control
• Wearing of tight-fitting clothing
• Uncontrolled diabetes