Vaginitis refers to any inflammation or infection of the vagina. This is a common gynecological problem found in females of all ages, with one-third of females having at least 1 form of vaginitis at some time during their lives. When the walls of the vagina become inflamed, because some irritant has disturbed the balance of the vaginal area, vaginitis can happen.
Bacteria, yeast, viruses, or chemicals in creams or sprays, or even clothing can cause vaginitis. Sometimes, vaginitis happens from organisms that are passed between sexual partners. In addition, the vaginal environment is influenced by a number of different factors. These include a female's health, her personal hygiene, medicines, hormones (particularly estrogen), and the health of her sexual partner. A disturbance in any of these factors can trigger vaginitis.
The following are the most common types of vaginitis:
Candida or "yeast" infection
Each of these types of infection has a different cause and can present different symptoms. This makes diagnosis often complicated. In addition, more than 1 type of vaginitis may be present at the same time, with or without symptoms being present.
There are other causes of vaginal discharge that should be considered. These include gonorrhea and chlamydia. However, these organisms do not infect the vagina directly. If left untreated, gonococcal and chlamydial infections can lead to serious conditions, such as PID. PID increases a female’s risk of infertility, pelvic adhesions, chronic pelvic pain, and ectopic (tubal) pregnancy. Chlamydia is 1 of the most common sexually transmitted diseases in the United States. It often goes undiagnosed.
Yeast infections, as they are commonly called, are caused by 1 of the many species of fungus known as candida, which normally live in the vagina in small numbers. Candida can also be present in the mouth and digestive tract in both males and females.
Yeast is normally present and well-balanced in the vagina. Infection happens when something in a female's system upsets this normal balance. For example, an antibiotic to treat another infection may upset this balance. In this case, the antibiotic kills the bacteria that normally protects and balances the yeast in the vagina. In turn, the yeast overgrows, causing an infection. Other factors that can cause this imbalance to happen include pregnancy, which changes hormone levels. Also, diabetes, which allows too much sugar in the urine and vagina, can be a factor.
The following are the most common symptoms of a candida infection. However, each adolescent may experience symptoms differently. Symptoms may include:
A thick, white, cottage cheese-like vaginal discharge. It is watery and usually odorless
Itching and redness of the vulva and vagina
Pain with urination or sex
The symptoms of a vaginal candida infection may resemble other conditions or medical problems. Always talk with your health care provider for a diagnosis.
While any female can develop a yeast infection, the following females may be at an increased risk for the condition:
Females who have had a recent course of antibiotics
Females who are pregnant
Females who have diabetes that is not well-controlled
Women with HIV
Females who are using an immunosuppressant medicine
Females who are using high-estrogen contraceptives
Females who are undergoing corticosteroid therapy. This slows the immune system.
In addition to a complete medical history and physical and pelvic exam, diagnostic procedures for vaginal candida infections often include a microscopic exam of the vaginal discharge.
Specific treatment for candida will be determined by your health care provider based on:
Your age, overall health, and medical history
Severity of the symptoms
Your tolerance for specific medicines, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
Treatment for candida may include:
Antifungal vaginal creams and suppositories
Oral antifungal medicines
Yeast infections are the most commonly discussed vaginal infection. And bacterial vaginosis is actually the most common type of vaginitis in females of reproductive age. This infection is caused by bacteria, not yeast. With a bacterial vaginosis infection, certain species of normal vaginal bacteria grow out of control and trigger inflammation. The cause of bacterial vaginosis is not known.
The following are the most common symptoms of bacterial vaginosis. However, each adolescent may experience symptoms differently. Symptoms may include:
A milky, thin discharge at times, or a heavy, gray, and sometimes green, discharge
"Fishy" odor of discharge
The symptoms of bacterial vaginosis may resemble other conditions. Always talk with your health care provider for a diagnosis.
Specific treatment for bacterial vaginosis will be determined by your health care provider based on:
Bacterial vaginosis is caused by bacteria. It is generally treated with antibiotics.
Trichomoniasis, trichomonas, or trich as it is commonly called, is a sexually transmitted infection. It is caused by a 1-celled parasite called Trichomonas vaginalis. This parasite passes between partners during sexual intercourse. Since most males do not present symptoms with trichomoniasis, the infection is often not diagnosed until the female develops symptoms of vaginitis.
The following are the most common symptoms of trichomoniasis. However, each adolescent may experience symptoms differently. Symptoms may include:
A frothy, often musty-smelling, greenish-yellow discharge
Itching or burning in and around the vagina and vulva
Swelling or redness at the opening of the vagina
Light bleeding, especially after intercourse
Burning during urination
Discomfort in the lower abdomen
Pain during intercourse
Some females with trichomoniasis have no symptoms. The symptoms of trichomoniasis may resemble other conditions or medical problems. Always talk with your health care provider for a diagnosis.
Specific treatment for trichomoniasis will be determined by your health care provider based on:
Both partners must be treated for trichomoniasis to avoid reinfection. Treatment generally involves taking oral antibiotics. If a female has more than 1 sexual partner, each partner (and any of their other partners) should also be treated.
Viruses are a common cause of vaginitis, with most being spread through sexual contact. One type of virus that causes viral vaginitis is the herpes simplex virus (HSV, or simply herpes). Its primary symptom is pain in the genital area associated with lesions and sores. These sores are generally visible on the vulva, or vagina, but occasionally are inside the vagina. They can only be found during a pelvic exam. Often stress or emotional situations can be a factor in triggering an outbreak of herpes.
Another source of viral vaginitis is the human papillomavirus (HPV), a virus that is also transmitted through sexual contact. HPV is the main cause of cervical cancer in women. This virus also causes painful warts to grow on the vagina, rectum, vulva, or groin. However, visible warts are not always present. The virus is generally found by a test for HPV done with a Pap test.
Two HPV vaccines are effective in preventing infection by the particular strains of HPV that cause most cervical cancers. But they do not treat existing HPV infection or genital warts. One of the vaccines also is effective against genital warts as well as some cancers of the vulva, vagina, and anus. Both vaccines are approved for use in females between the ages of 9 and 26. One of the 2 vaccines is available for boys and men, ages 9 through 26, and protects against most genital warts. The vaccines are given as a 3-dose series.
Noninfectious vaginitis usually refers to vaginal irritation without an infection being present. Most often, this is caused by an allergic reaction to, or irritation from, vaginal sprays, douches, or spermicidal products. Noninfectious vaginitis may be also be caused by sensitivity to perfumed soaps, detergents, or fabric softeners.
The following are the most common symptoms of noninfectious vaginitis. However, each adolescent may experience symptoms differently. Symptoms may include:
Pelvic pain (particularly during intercourse)
The symptoms of noninfectious vaginitis may resemble other conditions or medical problems. Always talk with your health care provider for a diagnosis.
Specific treatment for noninfectious vaginitis will be determined by your health care provider based on:
Treatment for noninfectious vaginitis depends greatly on the cause. If the cause is a reaction to an irritant, the irritant should be avoided.
Crestwood Medical Center
One Hospital Drive
Huntsville, AL 35801