Vaginal Infections and Vaginitis

Most women have been there. You're distracted and squirming in your chair because it doesn't feel right down there. Perhaps there's a smell that's a little, well, funkier, than usual. You want to do something to make it stop, now.

Although it can be darned uncomfortable, it's not the end of the world. You could have an infection caused by bacteria, yeast, or viruses. Chemicals in soaps, sprays, or even clothing that come in contact with this area could be irritating the delicate skin and tissues.

It's not always easy to figure out what's going on, though. You'll probably need your doctor's help to sort it out and choose the right treatment.

Types of Vaginitis

Doctors refer to the various conditions that cause an infection or inflammation of the vagina as "vaginitis." The most common kinds are:

Although they may have different symptoms, a diagnosis can be tricky even for an experienced doctor. Part of the problem is that you could have more than one at the same time.

You could also have an infection without any symptoms.

What's Normal? What Symptoms Aren't?

A woman's vagina makes discharge that's usually clear or slightly cloudy. In part, it's how the vagina cleans itself.

It doesn't really have a smell or make you itch. How much of it and exactly what it looks and feels like can vary during your menstrual cycle. At one point, you may have only a small amount of a very thin or watery discharge, and at another time of the month, it's thicker and there's more of it. That's all normal.

When discharge has a very noticeable odor, or burns or itches, that's likely a problem. You might feel an irritation any time of the day, but it's most often bothersome at night. Having sex can make some symptoms worse.

You should call your doctor when:

  • Your vaginal discharge changes color, is heavier, or smells different.
  • You notice itching, burning, swelling, or soreness around or outside of your vagina.
  • It burns when you pee.
  • Sex is uncomfortable.

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Yeast Infection or Bacterial Vaginosis?

Two of the most common causes are related to organisms that live in your vagina. They can have very similar symptoms. Yeast infections are an overgrowth of the yeast that you normally have in your body. Bacterial vaginosis happens when the balance of bacteria is thrown off. With both conditions, you may notice white or grayish discharge.

How can you tell them apart? If there's a fishy smell, bacterial vaginosis is a better guess. If your discharge looks like cottage cheese, a yeast infection may be to blame. That's also more likely to cause itching and burning, though bacterial vaginosis might make you itchy, too.

And you could have both at the same time.

Spread Through Sex

You can get vaginal infections through sexual contact, too:

Women may not have obvious symptoms of these STDs. If you're sexually active (especially if you have multiple partners), you should talk to your doctor about getting tested for them at your annual checkup.

If left untreated, some of these can permanently damage your reproductive organs or cause other health problems. You could also pass them to a partner.

Non-Infectious Vaginitis

Sometimes itching, burning, and even discharge happen without an infection. Most often, it's an allergic reaction to or irritation from products such as:

  • Detergents
  • Douches
  • Fabric softeners
  • Perfumed soaps
  • Spermicides
  • Vaginal sprays

It could also be from a lower level of hormones because of menopause or because you've had your ovaries removed. This can make your vagina dry, a condition called atrophic vaginitis. Sexual intercourse could be painful, and you may notice vaginal itching and burning.

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Treatment

The key to treating vaginal infections effectively is getting the right diagnosis.

Pay close attention to exactly which symptoms you have and when. Be ready to describe the color, texture, smell, and amount of discharge. Don't douche before your office or clinic visit; it will make accurate testing hard or impossible. Some doctors will ask you to not have sex during the 24-48 hours before your appointment.

It's better to see your doctor before you try over-the-counter medications, even if you're pretty sure you know what you have.

You treat non-infectious vaginitis by dealing with the probable cause. Consider what products you're using that could be irritating your sensitive skin. For hormonal changes, your doctor may prescribe estrogen to ease symptoms.

Prevent Vaginitis

Keep yourself clean and dry. But doctors don't recommend vaginal sprays or heavily perfumed soaps for this area. Douching may cause irritation, too, and more importantly, could hide or spread an infection. It also removes the healthy bacteria that do the housekeeping in your vagina.

Avoid clothes that hold in heat and moisture. Nylon underwear, tight jeans, non-breathable gym shorts and leggings, and pantyhose without a cotton panel can lead to yeast infections.

Eating yogurt with active cultures (check the label) might help you get fewer infections.

Condoms are the best way to prevent passing infections between sexual partners.

Get a complete gynecologic exam every year, including a Pap smear if your doctor recommends it.

WebMD Medical Reference Reviewed by Nivin Todd, MD on September 17, 2015

Sources

SOURCES:

National Institute of Allergy and Infectious Diseases: "Vaginitis."

Office of Women's Health: "Sexual Transmitted Infections Fact Sheet," "Bacterial Vaginosis," "Vaginal Yeast Infection."

American Academy of Family Physicians: "Vaginal Discharge."

The American College of Obstetrics and Gynecologists: "Vaginitis."

Hall Health Center, University of Washington: "Yeast Infections."

Planned Parenthood: "Yeast Infection & Vaginitis."

Egan, M. American Family Physician, 2000.

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