Vaginitis (Vaginal Infection)

Medically Reviewed by Poonam Sachdev on March 17, 2024
11 min read

Sometimes, things don't feel right "down there." One common cause is vaginitis. This means that your vagina (birth canal) is inflamed. It might be swollen, itchy, or sore. It might even smell strange or make an unusual discharge (liquid). If your vulva (the outside part of your genitals, including the labia and clitoris) is also affected, it is called vulvovaginitis.

There are many different types of vaginitis, and it can be caused by many different things. You could have an infection caused by bacteria, yeast, or viruses. Or chemicals in soaps, sprays, or even clothing could irritate the vagina's delicate skin. It could also be caused by vaginal dryness from hormonal imbalances.

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.

There are many types of vaginitis. The most common kinds are:

Bacterial vaginosis (BV). A healthy vagina has a balance of many different kinds of bacteria, yeast, and other microbes. But sometimes, the balance gets upset, and one microbe grows too much. BV happens when there's too much of one bacteria, usually Gardnerella vaginalis bacteria. It can cause a grayish white discharge with a strong fishy smell.

Candida or "yeast" infection. Candida yeast is a type of fungus. Small amounts of this fungus live in your mouth, digestive system, and vagina. This is perfectly normal and healthy. But too much can cause itchiness and discharge that looks and feels like cottage cheese.

Chlamydia. This is the most common sexually transmitted infection (STI), especially among people ages 15-24 years who have multiple sex partners.

Trichomoniasis. This infection is caused by a parasite spread during sex. It causes a yellow green, frothy discharge. It raises your risk of other STIs.

  • Viral vaginitis is inflammation caused by a virus, like the herpes simplex virus or human papillomavirus. Both spread through sex. They can cause painful sores or warts.
  • Noninfectious vaginitis is when something irritates your vagina. It's often caused by chemicals in soaps, douches, and other hygiene products. You might be allergic to these products, or your vagina might be sensitive.
  • Vaginal atrophy is when you have low estrogen levels. It usually happens after menopause or surgical removal of the ovaries. The hormonal changes can make the vagina dry, thin-skinned, and easily irritated.

It can be hard for even an experienced doctor to tell the difference. Many types of vaginitis have similar symptoms, and you could have more than one at the same time. Meanwhile, some might not cause any symptoms.

Vaginitis vs. vaginosis

Vaginitis is an infection or inflammation of the vagina. It can be caused by many things. The most common cause is BV. This is when too much of a certain bacteria grow in the vagina.

Vaginitis during pregnancy

When you're pregnant, your hormone levels change. This can lead to yeast infections, BV, and other forms of vaginitis.

It's especially important to take care of vaginitis when you're pregnant. That's because it can cause health problems for your baby. For example, babies whose mothers had BV during pregnancy are at a higher risk of being born too early and too small.

Yeast infection vs. BV

For people who haven't gone through menopause yet, these are the two most common forms of vaginitis. But they can be hard to tell apart.

Yeast infections are an overgrowth of the yeast that you normally have in your body. BV 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, BV is a better guess. If your discharge looks like cottage cheese, a yeast infection may be to blame. A yeast infection is also more likely to cause itching and burning, though BV might make you itchy, too.

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

Vaginitis can be caused by microbial imbalances, STIs, chemicals, or hormonal imbalances.

Microbial imbalances

A healthy vagina has certain bacteria and other microbes. Usually, there are many different kinds of microbes, and they all live in balance. You might hear this called your vaginal microbiome or flora.

But some things can upset this balance. When this happens, one microbe can grow too much, or an unwelcome microbe can take hold and cause an infection. This can lead to vaginitis.

Microbial imbalances can be caused by:

Antibiotics. Antimicrobial drugs, including antibiotics, are medicines that kill germs. Antibiotics kill unfriendly germs, but they also can kill friendly germs. When you take antibiotics for a urinary tract infection or other illnesses, they can kill the friendly germs in your vagina. This leaves extra room for other microbes to grow.

Diabetes. This can cause too much sugar in your pee and vagina. The extra sugar affects which types of microbes can grow there.

Immunosuppressants or biologics. These drugs treat some autoimmune conditions. They can raise your risk of yeast infections.

Imbalances like BV aren't spread by sex. But they are more common among people who have sex regularly. BV is also more common among people who have more than one sex partner, douche, or smoke cigarettes.


Many types of vaginitis are caused by STIs. These are infections that spread through sex, including anal and oral sex. Condoms, dental dams, and other barrier methods can help prevent some (but not all) STIs.

These infections might or might not cause symptoms. So if you have sex regularly (especially if you have multiple partners), you should talk to your doctor about getting tested for them at your yearly 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.


Not all vaginitis is caused by imbalances or infections. Sometimes, it's caused by allergic reactions to or irritation from chemicals in hygiene products. The skin of the vagina is very delicate, so it can be more sensitive than other body parts.

Inflammation can be caused by products like:

  • Detergents
  • Lotions
  • Over-the-counter odor or itch products
  • Wipes
  • Douches
  • Fabric softeners
  • Perfumed soaps
  • Lubricants
  • Spermicides
  • Vaginal sprays

If you think something is irritating your vagina, stop using it.

Hormonal imbalances

Low hormones, especially estrogen, can cause your vagina to be dry. This affects the balance of microbes in your vagina. It's called atrophic vaginitis, vulvovaginal atrophy, or genitourinary syndrome of menopause.

It can happen when:

  • You're pregnant.
  • You've recently given birth.
  • You're breastfeeding.
  • You are going through menopause.
  • You've had your uterus or ovaries removed.
  • You take certain medications for breast cancer or endometriosis.

Risk factors

Some things can make you more likely to get vaginitis. These include:

  • Antibiotics or steroids
  • Birth control pills that have a lot of estrogen
  • Spermicides
  • Intrauterine devices
  • STIs
  • Pregnancy
  • Unmanaged diabetes
  • Immune problems
  • Thyroid or endocrine problems
  • Hygiene products like perfumed soaps or vaginal sprays
  • Douches
  • Wet or tight-fitting clothing

Symptoms of vaginitis depend on what is causing it. Sometimes, you might not have any symptoms at all. In general, 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.
  • You have chills, fever, and pain in your pelvis.

Itchiness or irritation can happen anytime but are often worse at night. Having sex also can make symptoms worse.

Vaginitis discharge

Your vagina makes a discharge that's usually clear or slightly cloudy. In fact, that's one way it cleans itself.

Healthy discharge 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. Sometimes, you might have a thin or watery discharge. Toward the end of your cycle, it might be thicker. That's all normal.

But if your discharge smells, looks or feels unusual, or is itchy, it could be a sign of a problem. Different types of vaginitis affect your discharge in different ways. Depending on the cause, it could become thick and clumpy like cottage cheese (yeast infections), frothy and yellowish green (trichomoniasis), smelly like bad fish (BV), or change in other ways. Talk to your doctor about any unusual discharge.

If you're noticing changes in your discharge or other symptoms, your doctor can check things out to see how best to treat you. They'll ask you about your medical history, including your sexual history. They'll also want to know if you've been using anything that may be causing your vaginitis, like new detergent or spermicide.

Your doctor will also take a sample of your discharge or send it to a lab so it can be examined under a microscope to see what kind of vaginitis you have.

If you've had vaginitis before and recognize your symptoms, you may be able to treat the problem yourself without seeing your doctor, like if you've had a yeast infection before and you're sure your symptoms point to another yeast infection.

How you treat vaginitis depends on the cause. It's important to talk to your doctor about getting the right diagnosis and treatment because many different types of vaginitis can cause similar symptoms. Finding the cause is crucial to getting the right treatment.

First, your doctor will ask about your symptoms. Try to be as specific as possible. Be ready to describe the color, texture, smell, and amount of discharge you're having. The doctor might look inside your vagina for signs of infection, and they might check its acidity levels or swab it to test for certain conditions.

Don't douche before your doctor's appointment. This can make it harder to test for some infections. Also, some doctors will ask you to not have sex during the 24-48 hours before your appointment.

Depending on what type of vaginitis you have, your doctor might prescribe medicine like antibiotics or antifungals. But these don't work for all types. In fact, using the wrong medicine can make vaginitis worse. That's why it's better to see your doctor before you try over-the-counter medications.

Make sure you follow the directions from your doctor or the medicine's packaging. Use the entire supply of medicine, even after you feel better. If you finish the medicine and the symptoms haven't gone away (or they come back), call your doctor.

Ask your doctor how long you should wait to have sex after getting treatment. You may also need to disinfect sex toys using the instructions on the box.

If you don't have a microbial imbalance or infection, the vaginitis could be caused by allergies or chemical irritants. Your doctor may want to know if you've been using anything that may be causing your vaginitis, like new detergent or spermicide. Think about what products you use down there. If you've recently started a new product, try stopping it and seeing if that helps. You also can try switching products to find something that is less irritating.

If your vaginitis is caused by hormonal changes, your doctor might prescribe estrogen. This could be in the form of a pill, cream, or vaginal ring.

Vaginitis creams

Common antifungal creams and suppositories for yeast infections are:

  • Clotrimazole (Gyne-Lotrimin)
  • Miconazole (Monistat)
  • Tioconazole (Vagistat)

There are many over-the-counter options for treating yeast infections that are safe and effective. If you've never had a yeast infection, check with your doctor before you take them. You should also talk to your doctor if you take over-the-counter medications and don't see any change in your symptoms.

You can treat both BV and trichomoniasis with a medication called metronidazole (Flagyl). When you're treating trichomoniasis, you take it in pill form by mouth. You can also take metronidazole to treat BV, or you can use clindamycin topical (Cleocin T) or metronidazole gel (MetroGel Vaginal) in your vagina.

Vaginitis antibiotics

Some types of vaginitis can be treated by antibiotics. The antibiotics could be pills, or they might be a gel or cream that you put on your vagina. You should feel better about two weeks after starting antibiotics.

It's important to talk to your doctor before starting antibiotics or other treatments. If you use the wrong medicine, it could make things worse.

How long does vaginitis last?

With treatment, vaginitis caused by bacteria or fungus can get better in 2 weeks. Treatment can make the symptoms of viral vaginitis go away, but it won't cure it. Some people have a hard time getting rid of vaginitis. In these cases, it could take 3-6 months to get better.

You should always talk to a doctor to find out what is causing your vaginitis and how to treat it. Some mild cases can go away on their own, but many require medicine. Not treating vaginitis can cause other problems, like raising your risk of more STIs.

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.

Vaginitis is when your vagina becomes itchy, swollen, or inflamed. You also might notice discharge that feels, smells, or looks different than usual. It can be caused by infections, irritation from chemicals, imbalances in the vaginal flora, or hormone changes. If you have vaginal irritation or unusual discharge, talk to your doctor right away.

How long does vaginitis last?

If your vaginitis is caused by bacteria or fungi, treatment can help it get better in 2 weeks. If you have a long-term or returning case, it could take 3-6 months to get better.

Can vaginitis cause bleeding?

Vaginitis can cause some light bleeding and spotting.

Does vaginitis go away on its own?

Always talk to your doctor about what is causing your vaginitis and how to treat it. Although some mild cases can go away on their own, many require medication. Leaving vaginitis untreated can cause other problems, like raising your risk of STIs.