Vaginitis

What is vaginitis?

Vaginitis is an inflammation of the vagina characterized by itching, pain, as well as abnormal odor and discharge. This condition is usually a result of an infection such as bacterial vaginosis, a yeast infection or trichomoniasis, but can also be due to a change in hormone levels, an immune issue like an allergy, or anything that disrupts the normal balance of the vaginal microbiome [1,2,3]. 

Before we go any further, it’s important to note the difference between vaginitis and vaginosis. Anything ending in itis is talking about a state of inflammation, whereas the ending osis refers to an abnormal condition. We wanted to clear up any confusion because some types of vaginosis can lead to vaginitis. 

How common is it?

According to the American College of Obstetricians and Gynecologists, a third of women will experience vaginitis at some point in their lives. This is a very common condition for women in their reproductive years in particular [3]. 

What causes vaginitis and who is at risk?

Although there are no universally accepted set of causes, we can think of them as falling into one of two categories: infectious and non-infectious.

Infectious

• Candidiasis, also known as a yeast infection
• Bacterial vaginosis (BV)
• Aerobic vaginitis (AV)
• Common STIs like gonorrhea, chlamydia or herpes 
• Infections from parasites like trichomonas
• Other bacteria such as mycoplasma and ureaplasma
  

Non-infectious 

• Hormonal changes due to pregnancy, breastfeeding or menopause. For example, atrophic vaginitis (a thinning, drying and inflammation of the vaginal walls) often occurs in post-menopausal women due to a drop in estrogen levels.
• Anything that someone might be allergic to or cause irritation in the vagina such as douching, spermicides, or the use of scented perfumes and soaps. 
  

You should probably also know there can be more than one cause of vaginitis at a time. Risk factors for developing vaginitis include anything that might result in the disruption of your vaginal microbiome which in turn leads to one of the causes listed above. This includes taking antibiotics which kills normal vaginal bacteria, douching, using perfumed soaps or gels and having unprotected sex. Women who have diabetes, are pregnant or have a weakened immune system are also at a higher risk.

What are the symptoms?

Vaginitis causes several symptoms that vary in severity from mild to debilitating. They include vaginal itching, pain, burning, unusual discharge, as well as potentially bad odors or dryness depending on the root cause of the vaginitis [2]. 

How is it diagnosed?

Vaginitis is easily diagnosed by your gynecologist based on the description of symptoms. The trickier part is identifying the root cause of the vaginitis which requires a differential diagnosis, meaning your doctor will seek to identify the cause by distinguishing it from other conditions that might have similar symptoms using both your reported symptoms and a number of laboratory tests. 

Can vaginitis lead to other complications?

Left untreated, the underlying conditions that cause vaginitis can lead to pregnancy complications, infertility, and pelvic inflammatory disease [2, 3].

What are the treatment options?

The vaginal irritation itself can be relieved with cortisone, but effective treatment requires addressing the underlying root cause. Once an infection has been accurately diagnosed, specific antibiotics are often prescribed. If atrophic vaginitis is suspected, estrogen might be administered. 

What can be done to prevent vaginitis?

The only way to prevent vaginitis is to avoid disrupting the balance of bacteria within the vaginal microbiome which can lead to one or more of the causes listed above. To maintain that balance, limit the use of douches as well as scented soaps, tampons or pads. In addition, you can reduce your chances of getting an STI, practice safe sex by always discussing sexual health with your partner, using barrier protection correctly (such as a condom or dental dam), and getting tested regularly.