Vaginitis is the inflammation of the vagina. It’s due to an imbalance of yeast and bacteria that normally live in the vagina. Many triggers can cause an infection in the vagina and vulval areas. The most common cause is bacteria. Other common causes include:
- environmental factors
- sexually transmitted infections (STIs)
- exposure to chemical irritants and allergens
Infection is the most common cause of vaginitis, including candidiasis, bacterial vaginosis, and trichomoniasis. Less commonly, vaginitis may also be caused by gonorrhea, Chlamydia, mycoplasma, herpes, campylobacter, some parasites, and poor hygiene. Vaginitis can occur before puberty, but different types of bacteria may be involved. Before puberty, Streptococcus spp is a more likely cause, sometimes because improper hygiene practices spread bacteria from the anal area to the genitals.
The proximity of the vagina to the anus, lack of estrogen, lack of pubic hair, and lack of labial fat pads may increase the risk of vulvovaginitis before puberty. Vulvovaginitis is an inflammation of the vagina and vulva. It can affect women of all ages.
After puberty, infection is most often due to Gardnerella. Sometimes, vaginitis can stem from an allergic reaction, for example, to condoms, spermicides, certain soaps and perfumes, douches, topical medications, lubricants, and even semen. Irritation from a tampon can also cause vaginitis in some women.
Factors that increase the risk of vaginitis include:
- douching and using vaginal products, such as sprays, spermicides, and birth control devices
- using antibiotics
- wearing tight pants or damp underwear
- low estrogen levels during menopause
- Women with diabetes are particularly prone
The following best practices may help prevent vaginitis:
- having good overall hygiene
- using mild soaps without irritants or scents
- wearing cotton underwear
- avoiding douching and irritating agents, such as those present in hygiene sprays, soaps, and other feminine products
- wiping from front to back to avoid spreading bacteria from the anus to the vagina
- wearing loose-fitting clothing
- practicing sex with a condom
- using antibiotics only when necessary
Vaginitis transmitted through sex
The STI trichomonas vaginitis can cause vulvovaginitis. This infection causes genital discomfort, itching, and a heavy discharge. The discharge can be yellow, green, or gray. It often has a strong odor. Chlamydia, gonorrhea, and herpes can also cause vaginitis.
Your doctor will diagnose vulvovaginitis by discussing your symptoms and possibly collecting a sample of vaginal discharge to test.
In most cases, your doctor will need to perform a pelvic examination. A wet prep may be necessary to correctly identify the cause of your inflammation. This involves collecting some vaginal discharge for microscopic evaluation.
Your doctor can then identify the organism causing the condition, leading to quicker and more successful treatment.
In rare cases, it may be necessary to biopsy the vulva to identify the organism. This means your doctor will take a small sample of tissue for further examination. A biopsy is typically only necessary if traditional treatment methods are unsuccessful.
The correct treatment for vulvovaginitis depends on the type of infection and the organism causing the problem. It’s possible to treat some types of vulvovaginitis on your own. But be sure to speak with your doctor before initiating any home treatment.
Treatment depends on the cause. It may include low-potency topical steroids, applied to the skin, topical or oral antibiotics, antifungals, or antibacterial creams. Bacterial vaginitis (BV) is usually treated with antibiotics, such as metronidazole (Flagyl), or clindamycin. Medications used to treat a fungal infection include butoconazole and clotrimazole.
Other options include:
- Cortisone cream to treat severe irritation.
- Antihistamines, if the inflammation appears to stem from an allergic reaction.
- Topical estrogen cream, if the vaginitis is due to low estrogen levels.
If you’ve had a yeast infection in the past, you may be able to treat vulvovaginitis using over-the-counter products available at any pharmacy, including:
- vaginal creams
- topical ointments
- oral pills
A pharmacist can likely advise you on the best product for your symptoms and how to apply the product. Crushed garlic and coconut oil, both known for their antibacterial properties, may also help treat the condition.
You may be able to relieve some of the symptoms of your vulvovaginitis by sitting in a sitz bath (a warm, shallow bath that only covers your hip area). Adding tea tree oil or a trace amount of vinegar or sea salt to the bath may help kill some bacteria if that’s the cause of your symptoms.
Be careful not to sit in the bath for too long. Use a towel to dry the affected area completely after your bath. Consult your doctor if the inflammation or discharge doesn’t improve after a week of home treatment.