Vaginitis is a condition in which the walls of the vagina become irritated or infected, causing discharge, itching, irritation, and discomfort. Vaginitis may also cause vaginal bleeding, pain in the lower abdomen, and pain during sexual intercourse. About 75 percent of women will have at least one vaginal infection in their lifetime, and 22 million will have repeat infections. The five most common types are atrophic vaginitis, vaginal yeast infections, chemical vaginitis, BV (bacterial vaginosis), and trichomoniasis.
Atrophic Vaginitis
This vaginal irritation causes no discharge. It is brought about by a low level of estrogen caused by menopause, removal of the ovaries, pelvic radiation treatments, certain kinds of chemotherapy, and childbirth, especially when followed by breast-feeding. Low estrogen levels also make vaginal tissue become thinner and drier. Women may also notice spotting caused by tearing of the dry skin.
Sexually active women with atrophic vaginitis experience painful intercourse and may need to use lubricants or engage in other types of sex play. Estrogen vaginal creams or oral tablets can rebuild the vaginal tissue, restore lubrication, and decrease irritation.
Yeast Vaginitis
Many different bacteria and organisms live in a healthy vagina. They don’t usually cause any problems because there are not too many of one kind. Yeast vaginitis is an inflammation of the vagina that is caused by a change in the normal balance of vaginal bacteria or yeasts. The most common cause is an overgrowth of yeasts from a family called Candida. Symptoms include:
• thick, cottage cheese-like vaginal discharge
• a yeasty odor
• itching or irritation of the vagina and/or the vulva
Persistent or recurrent vaginitis may lead your clinician to evaluate you for diabetes or other diseases—although these are not common causes. Women may also have chronic vaginitis because of the altered balance of bacteria in their lower bowels. The abnormal balance of bacteria in the bowel may create an overgrowth of yeast that is reflected in the vagina. Fecal bacteria may also enter the vagina through sweat, wiping, and sexual activity. If the bowel bacteria are not in healthy balance, the vaginal bacteria may become altered with a resulting chronic vaginitis. Bacterial imbalances are commonly the result of overuse of antibiotics and a high-sugar diet.
Chemical Vaginitis
Objects and chemicals left in the vagina may cause irritations that lead to vaginitis. Do not leave tampons, toilet tissue, contraceptives, or other objects in the vagina longer than necessary. Some women have very sensitive skin in the vulvar area—often because of a recent infection. The skin may be further irritated by scented toilet paper or tampons, vaginal sprays, and soap and shampoo residue. Other possible irritants are latex condoms, diaphragms and cervical caps, and spermicides.
Bacterial Vaginosis (Â V)
BV is a condition caused by a change in the balance of vaginal bacteria. Normal lactobacilli decrease in number as the number of competing bacteria increase. Hundreds of thousands of women in the United States develop BV every year. It is not usually sexually transmitted, but it may be aggravated by sexual intercourse. It is not a true vaginitis because it is not an “inflammation” and does not cause irritation or itching. Common symptoms of BV include heavy and unusual vaginal discharge that is often thin and gray and may have a “fishy” odor, especially after intercourse.
The disturbed balance of vaginal bacteria that causes BV can be created by antibiotics or the presence of fecal material—as in diarrhea. It can be further intensified by introducing new bacteria through intercourse and the presence of a man’s ejaculate.
BV is diagnosed by microscopic examination of the vaginal discharge. Ironically, it is treated with antibiotics, either in vaginal gel or in pill form.
Trichomoniasis.
Treatment of yeast vaginitis
• Use over-the-counter antifungal creams, ointments, or suppositories or oral medications if your yeast infection has been verified by a clinician.
• Eat plain yogurt with live acidophilus culture, or take tablets containing the culture.
• Wear breathable underwear, panty hose with a cotton crotch, or loose-fitting pants.
• Do not share towels.
• Do not sit around in a wet bathing suit.
• Always wipe away from the vagina after bowel movements or urination.
• Some women find it soothing to apply yogurt directly to the vagina. Some soak a tampon in yogurt and insert it.
Additional treatments for recurrent yeast vaginitis:
• Avoid simple sugars and carbohydrates such as candy, cake, and ice cream.
• Limit or avoid foods containing yeasts, molds, or ferments such as cheese and bread.
• Use antifungal medicines, such as caprylic acid, citrus seed extracts, or garlic products. These can be found in most health food stores.
• Use antibiotics only if necessary.
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