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Vaginitis (Vaginal Infection)

What Is Vaginitis?

Vaginitis is inflammation of the vagina. It’s due to an imbalance of yeast and bacteria that normally live in the vagina.

Along with discomfort, you may notice a smell that's different than usual. 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 and Causes of Vaginitis

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

  • Bacterial vaginosis, inflammation of the vagina due to an overgrowth of bacteria. It typically causes a strong fishy odor.
  • Candida or "yeast" infection, an overgrowth of the fungus candida, which is normally found in small amounts in the vagina.
  • Chlamydia is the most common sexually transmitted infection (STI) in women, usually in those ages 18 to 35 who have multiple sex partners.
  • Gonorrhea is another common infection spread through sex. It often comes along with chlamydia.
  • Trichomoniasis is an infection spread by sex that’s caused by a parasite. It raises your risk for other STIs.
  • Viral vaginitis is inflammation caused by a virus, like the herpes simplex virus (HSV) or human papillomavirus (HPV), which spread through sex. Sores or warts on the genitals can be painful.

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Symptoms of sexually transmitted diseases (STDs) aren’t obvious. 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.

Sometimes, itching, burning, and even discharge happen without an infection (noninfectious vaginitis). 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 from having 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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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.

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You could also have an infection without any symptoms.

Yeast infection vs. bacterial vaginosis

Two of the most common causes of vaginitis 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 a 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.

It’s possible to have both at the same time.

Vaginitis Symptoms

A woman's vagina makes a 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.

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When your 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.

Vaginitis Treatment

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

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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 to 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 noninfectious 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.

Vaginitis Prevention

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. Douching is never recommended.

Avoid clothes that hold in heat and moisture. Nylon underwear, tight jeans, gym shorts and leggings that don’t breathe, 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 Arefa Cassoobhoy, MD, MPH on August 17, 2020

Sources

SOURCES:

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

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

American Academy of Family Physicians: "Vaginal Discharge."

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

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

Planned Parenthood: "Yeast Infection & Vaginitis."

American Family Physician: “Diagnosis of Vaginitis.”

Cleveland Clinic: “Vaginitis.”

The American College of Obstetrics and Gynecologists: “Chlamydia, Gonorrhea, and Syphilis.”

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