Vaginitis

Vaginitis is an inflammation of the vagina.  It is often caused by infections, some of which are associated with serious diseases. Some vaginal infections are transmitted through sexual contact, but others, such as yeast infections, are usually not.  The symptoms of a vaginal infection can include discharge, odor, itching or irritation.

The vagina naturally maintains a pH balance at which normal bacteria live. However, if this delicate balance is disrupted, vaginitis can occur.  There are many things that can affect this balance; among those are the following: 

• Antibiotics - Antibiotics destroy protective bacteria in the vagina, upsetting the balance between the bacteria and certain fungi called yeast.  Vaginitis may occur after taking a course of antibiotics for another condition such as strep throat.
• Diabetes - Both diabetes and pregnancy make the vagina better suited for fungal growth. These conditions lower the glycogen store in certain vaginal cells, and may also raise both the sugar content of the vagina.  This increases the risk of yeast infection.
• Hormonal changes – Ovulation, menopause and pregnancy affect hormone balances, as does the use of birth control pills.
• Steroid use – Steroids are prescribed for many conditions, including asthma.
• Sexual intercourse with a partner who is infected.  
• Weakened immune system due to infection
• Repeated use of douching preparations, or perfumed feminine hygiene sprays
• Scratches in the vagina, sometimes resulting from tampon insertion

Common Types

Three vaginal infections are the most common. Although the symptoms can be similar, their causes and treatments are different. Those three are:

1. Bacterial vaginosis – The bacteria that cause this condition are always present in the vagina.  When the amount of bacteria increases due to any of the above reasons, bacterial vaginosis occurs.  There are several different antibiotics used to treat bacterial vaginosis, and it often recurs, requiring repeated or long-term treatment.  If it does recur repeatedly, it is sometimes an indicator that another STD (sexually transmitted disease) is present.  The main symptom of bacterial vaginosis is an increased discharge, usually accompanied by an unpleasant “fishy” odor, which may be stronger during menstruation.  The discharge itself is thin and can be dark, dull gray, or greenish in color.  Itching does not usually occur unless there is a heavy discharge.
2. Vaginal yeast infection, or candidiasis – This infection is caused by an overgrowth of a fungus or yeast called candida.  The yeast are normally kept under control by the natural bacteria in the body.  When the balance is disrupted, the yeast grow uncontrollably.  When it grows beyond its normal level, it causes an itching or burning of the area outside the vagina called the vulva, which also may become tender and swollen.  Sometimes there is a white discharge, sometimes none at all.  
   Yeast infections are treated with antifungals, either taken orally or placed into the vagina.  Over-the-counter treatments are available for yeast infections, but if the infection is not caused by yeast, the treatment will be ineffective, and can make diagnosis of the real infection more difficult.  A women who has never had a yeast infection before is advised to see her healthcare provider before trying any over-the-counter medication. In addition, if the symptoms persist, or if the discharge is yellow/green or bad smelling, the physician/midwife should be consulted.  Nearly 75% of all adult women will have had at least one genital yeast infection in their lifetime. In addition, up to 15% of men will develop symptoms such as itching and penile rash following sexual contact with an infected partner.
3. Trichomoniasis - is a sexually transmitted disease caused by the parasite Trichomonas vaginalis.  Trichomoniasis is primarily an infection of the urinary and genital tract. For women, the vagina is the most common site of infection. For men, the urethra is most commonly affected.

Symptoms usually appear within 5 to 28 days after contact with the parasite.  They include:

• Heavy, yellow-green or gray vaginal discharge
• Discomfort during sex
• Vaginal odor
• Painful urination

Women also may have irritation and itching of the genital area and, on rare occasions, lower abdominal pain.  Most infected men do not have symptoms. If they do, the symptoms include a thin, whitish discharge from the penis and painful or difficult urination and ejaculation.
Trichomoniasis is usually treated with a single dose of an antibiotic.

Other Causes of Vaginal Infection

Some other things that may cause a vaginal infection may be allergies to spermicides, vaginal hygiene products, and detergents and fabric softeners. Another type of sexually transmitted disease may be present. Older women may experience a thinning of the vaginal walls with menopause, a condition known as atrophic vaginitis.

Preventing Vaginitis

While many causes of vaginitis are unavoidable, there are some things that you can do to lower your risk of getting vaginitis. 

• It is often a good idea to avoid garments that hold in heat and moisture. The wearing of nylon panties, pantyhose without a cotton panel, and tight jeans can lead to yeast infections. Good hygiene is also important.
• Avoid vaginal sprays or heavily perfumed soaps for cleansing this area.  Also, overuse of douching may cause irritation or may even hide a vaginal infection.
• If you are prescribed antibiotics or steroids for another condition, discuss with your physician or midwife the best way to prevent a yeast infection.
• Condom use is particularly important to prevent the passing of diseases between partners.
• If you have low levels of estrogen for any reason, discuss with your doctor the use of hormone pills or creams to keep the vagina lubricated and healthy.

Remember

If you experience any kind of abnormal discharge, burning or itching, contact your healthcare provider.  Properly diagnosed, vaginitis can nearly always be successfully treated.