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What is Vaginitis?

What is Vaginitis?

What is Vaginitis?

By Jennifer Evans, M.D.

Vaginitis causes redness, swelling and irritation of the outer genitalia as well as discharge from the vagina. Some vaginal discharge is normal; however, the discharge may be a sign of infection. Vaginitis affects up to one third of women during their lifetimes and accounts for over 10 million office visits each year. To receive the correct diagnosis and treatment, it is important that you see your doctor.

It is normal to have a small amount (less than 5 cc) of clear or white odorless discharge each day. The discharge is more noticeable if you are on oral contraceptive pills or midway through your menstrual cycle. An abnormal discharge is one that causes itching and burning or has an abnormal odor. These are the most common symptoms of vaginitis and should prompt a visit to your doctor.

The most common types of vaginitis are caused by yeast and bacterial vaginosis. Sexually transmitted diseases such as gonorrhea, chlamydia and trichomonas can result in vaginal discharge. Human papilloma virus (HPV), herpes and syphilis can cause lesions of the genitalia.

Your doctor will need to know your symptoms and perform an examination. A sample of the discharge will be evaluated under the microscope and possibly sent for culture. It is important to not douche or use any medications for 1-2 days before your visit.

The most common cause of vaginitis is bacterial vaginosis. This infection is caused by an overgrowth of bacteria in the vagina. The most common symptom is an unpleasant, "fishy-smelling" discharge that is more noticeable after sexual intercourse. The discharge is often grayish white or yellow in appearance. This infection is usually treated with an antibiotic such as metronidazole or clindamycin. Recurrent infections are common and may require repeated treatment.

Yeast infections are very common and are caused by an overgrowth of candida. Candida is a fungus normally found in the vagina, but can cause problems when there is an excessive amount present. The use of antibiotics can increase the risk of yeast infection because antibiotics kill the bacteria that keep yeast growth in check.

The most common symptoms of yeast infections are redness, itching and burning of the vagina and vulva. The discharge is usually thick and white. You can decrease your risk of developing a yeast infection by wearing cotton underwear and minimizing the time that you are in wet clothing, i.e. swimsuits and workout clothing. Treatment consists of taking a pill or placing a medication in the vagina.

Diabetes and pregnancy increase the risk of yeast infections.

SEXUALLY TRANSMITTED VARIETIES

Trichomonas is the third most common cause of vaginitis. It is caused by a one-celled protozoan organism. This infection is virtually always sexually transmitted. Some women don''t have symptoms. However, the most common symptoms are a yellow-gray discharge with an unpleasant odor. Burning and irritation are common and may increase with urination. Redness and swelling of the vulva are common. This infection is treated with metronidazole - the same medication used to treat bacterial vaginosis. It is very important that the sexual partner is treated. Men usually don''t have symptoms. Condoms reduce the likelihood of transmitting this infection.

Genital herpes is a sexually transmitted disease caused by a virus, which causes painful blisters and itching of the external genitalia. Some people experience burning with urination. The lesions usually appear 2 to 20 days after contact with the virus and can last up to 3 weeks. Approximately 20 percent of Americans have been infected with herpes and there are up to one million new cases each year. Many people have never been diagnosed and are unaware that they have been infected. Anti-viral medications can shorten the duration of symptoms and decrease recurrences. There is not a definitive cure for herpes.

Human papilloma virus (HPV) is a virus that is one of the most common sexually transmitted diseases. HPV can cause warts, which may appear on the vulva or inside the vagina. Men can get lesions on the penis. The warts can be pink, red, flesh-colored or brown and spread to nearby skin. The warts may go away over time, but the virus may remain in the body. Some types of HPV are associated with cancer. It is important that you have an exam with a Pap smear to detect this disease. HPV cannot be cured, but the warts can be treated. Condoms decrease the risk of transmission.

Gonorrhea, chlamydia and syphilis are sexually transmitted diseases caused by bacteria. Symptoms of gonorrhea and chlamydia can include vaginal discharge, itching and burning. Syphilis can include a sore or rash. These diseases can be diagnosed with special cultures or blood tests. The treatment for these sexually transmitted diseases is antibiotics.

SOME VAGINITIS NOT CAUSED BY INFECTION

Vaginitis is not always caused by an infection. Postmenopausal women who are deficient in estrogen can develop atrophic vaginitis. An allergic reaction to chemicals or perfumes in soaps, tampons or pads can result in these symptoms. Chemicals in douches, powders, sprays and spermicides can cause irritation. Most doctors recommend that you not douche because it can change the natural environment of the vagina. Also, some women are allergic to the latex in condoms.

In summary, there are many causes of vaginitis. It is important that your doctor evaluate you in order to obtain the correct diagnosis and treatment.

Jennifer Evans, M.D., is a partner at Associates in OB/GYN. She received her M.D. and master''s of public health degrees from Tulane University. She completed her residency in obstetrics and gynecology at the University of Louisville.

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