Vaginitis is the medical term for inflammation and irritation of the vagina, often associated with vaginal itching, pain and discharge. It is easy to find these symptoms embarrassing, and to feel like you’re all alone. However, despite the fact that women tend not to talk about them, vaginal infections are very common, accounting for more than 10 million trips to the doctor every year. These infections are unlikely to go away on their own, so seeking proper treatment is essential.

What causes vaginitis?

Vaginitis is most often the result of a vaginal infection; the majority of infections are caused by bacteria, fungus (yeast) and parasites.

• Bacterial vaginosis is the most common form of vaginitis. This bacterial infection of the vagina occurs when the normal healthy bacteria that live in the vagina are replaced with a mix of harmful bacteria.
• Candida vaginitis is the next most common vaginal infection, caused by a fungus known as Candida. These infections are commonly known as yeast infections, and result when conditions in the body permit an overgrowth of yeast in the vagina.
• Trichomonas vaginitis is the third most common cause of vaginal infections, and is considered a sexually transmitted disease (STD). The Trichomonas parasite is passed to a woman during sexual intercourse.

Vaginitis can also have noninfectious causes; postmenopausal women can suffer from atrophic vaginitis, or vaginal irritation and dryness related to low estrogen levels. Soaps and feminine hygiene products can irritate the vagina, causing allergic vaginitis.

How do I know if I have vaginitis?

Symptoms of vaginitis include vaginal discharge, vaginal itching and burning and pain with sexual intercourse. The different types of vaginal infection may have more specific symptoms. Bacterial vaginosis can be associated with an unpleasant ‘fishy’ vaginal odor. Candida vaginitis can cause intense vaginal itching and a thick white ‘cottage-cheese’-like vaginal discharge. Trichomonas can be associated with large amounts of yellow-green vaginal discharge and pain during sexual intercourse.

How do I treat vaginitis?

Many women are tempted to treat vaginitis on their own, with over-the counter medications such as Monistat. However, these medications only treat yeast infections, which account for around 30-40% of all vaginal infections. This would mean that up to 70% of women using over-the-counter remedies for vaginitis could be receiving inappropriate or inadequate treatment.

Your doctor or midwife can run specific tests on a sample of vaginal fluid that can help determine whether your infection is due to bacteria, yeast or trichomonas. After the infectious agent is identified, your doctor can prescribe an appropriate course of treatment. This usually consists of a 1-7 day course of medicine either taken orally or placed in the vagina in cream or gel form. Adequate treatment is especially important in pregnant women, since untreated infections can result in pregnancy complications, including premature labor and low birth weight.

How can I decrease my risk for vaginitis?

The best defense against vaginal infections is a balanced vaginal environment containing healthy lactobacillus bacteria. You should avoid the use of douches and other feminine hygiene products that disrupt the normal balance of the vaginal fluid. Taking lactobacillus in the form of pills or yogurt with live cultures is not harmful, but has not been proven effective in treating or preventing vaginal infections. Safe sexual practices including monogamous relationships and condom use can lower your risk of trichomonas infection. These practices may also lower your risk of bacterial vaginosis, which is considered ‘sexually-related’ rather than ‘sexually-transmitted’.