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Pelvic Health

What is Vaginitis? Causes, Symptoms and More

What is Vaginitis? Causes, Symptoms and More

by Dr. Barb DePree, MD


Vaginitis is the medical term for any type of inflammation of the vagina and is known to occur in over 30% of women at least once in their lifetime. Essentially, when something irritates the vagina or upsets the natural balance of the vaginal environment, vaginitis occurs in the form of itching, swelling, and other symptoms.

In this article, we’ll discuss what causes vaginitis, the types of vaginitis, as well the symptoms of each, and how they are treated.   

Vaginitis: What Causes It?

Several factors can cause vaginitis, including an overgrowth of harmful bacteria or fungi in the vagina. Parasites and viruses passed between sexual partners are also at the root of some forms of vaginitis.

Irritation or allergic reactions to fragranced hygiene products or washing detergents as well as hormonal fluctuations and douching are additional factors known to cause vaginitis.  

Different Types of Vaginitis

Yes, there are numerous types of vaginitis, the most common of which are listed below.

  • Bacterial vaginosis
  • Yeast Infections
  • Trichomoniasis vaginitis
  • Viral vaginitis
  • Noninfectious vaginitis

1. Bacterial Vaginosis: What Is it?

Bacterial vaginosis (BV) is caused by an overgrowth of harmful bacteria that are naturally found in the vagina called Gardenella Vaginalis. BV is most commonly diagnosed in sexually active women aged 14-45 but is also known to occur in women of any age.

Over 50% of women suffering from BV notice no symptoms of irritation or infection and it is often diagnosed during pap smear, much to the surprise of the patient. 

When BV symptoms do occur, they typically present as:

  • Thin, gray-colored vaginal discharge
  • Unpleasant (fish-like) vaginal odor from the discharge, especially after sex 
  • Burning sensation while urinating
  • Vaginal itching
  • Pain or discomfort during sex
  • Fever (but not for all women)

BV symptoms often appear similar to those associated with yeast infections (see below), but the thin gray vaginal discharge with an unpleasant odor is the key difference. Vaginal discharge from a yeast infection is typically thick, white, odorless, and often (but not always) lumpy like cottage cheese. 

Causes of Bacterial Vaginosis?

Vaginas are essentially self-cleaning machines, naturally capable of balancing good bacteria with harmful bacteria to maintain a healthy environment and balanced pH levels that ward off possible vaginal infections.

However, if the vaginal flora becomes unbalanced, pH levels are altered, and the vaginal environment becomes suitable for harmful bacteria like Gardnerella Vaginalis to thrive, resulting in bacterial vaginosis. 

While researchers cannot exactly pinpoint the exact cause of BV, several hygiene habits and lifestyle factors that alter the vaginal environment are known to increase the risk of infection. These include:

  • Douching
  • Smoking
  • Sex without a condom
  • Multiple sexual partners
  • A new sexual partner
  • Sex with a female who has BV
  • Using fragranced menstrual products or scented soaps

How to Treat Bacterial Vaginosis 

Upon confirming the presence of a bacterial infection, either through a routine pap smear or due to the presence of symptoms, a doctor will prescribe antibiotics as treatment. However, because BV is known to re-occur in up to 50% of women, female health experts recommend taking a natural Boric Acid Supplement in conjunction with antibiotics. 

Although boric acid possesses antimicrobial and antiseptic properties that help to restore the natural bacterial balance in the vagina, it should not be relied upon to treat BV on its own. Antibiotics are always required to treat bacterial infections, but boric acid supplements certainly speed up the healing process and prevent infections from recurring.  

2. Yeast Infection: What Is it?

A yeast infection, also known as Vaginal Candidiasis, is caused by an overgrowth of a fungus called candida and is known to affect more than 75% of women at least once in their lifetime.

The vagina normally balances the presence of candida, or yeast, with the help of a healthy bacteria called lactobacillus. However, if this natural balance is upset, candida goes into overgrowth and causes a yeast infection.

Symptoms of a yeast infection commonly include the following:

  • A thick, white, odorless, cottage cheese-like vaginal discharge
  • Itching 
  • Irritation, swelling & redness of the vulva and vagina
  • Burning sensation during urination 
  • Pain during sex

What Causes Yeast Infections?

Yeast infections occur when something disturbs the natural balance of fungus in the vagina. For instance, taking antibiotics for another condition often destroys the ‘good’ bacteria that help keep vaginal yeast in check, allowing it to flourish and result in an infection. 

Women who use oral contraceptives are considered more susceptible to yeast infections, as well as those with a compromised immune system, uncontrolled diabetes, or unhealthy eating habits. Pregnant women are also known to be more prone to yeast infections, in addition to women experiencing stress or hormonal fluctuations.

Treatment for Yeast Infections

Yeast infections are usually treated with over-the-counter medication in the form of antifungal creams, medicine, or vaginal suppositories. That said, if you suffer from recurring yeast infections, as is common for many women, female health experts recommend taking a full course of Boric Acid Suppositories in conjunction with the antifungal treatment. 

Finishing a complete course of Boric Acid Balance Suppositories helps to rejuvenate the natural bacterial balance in the vagina and prevent recurring yeast infections.  

3. What Is Trichomoniasis?

Trichomoniasis, which is also referred to as trich, is one of the most common sexually transmitted infections (STIs) globally. Women are considered more prone to trichomoniasis than men with over one million sexually active females diagnosed with trich each year.

As per the research carried out by the CDC, however, up to 85% of women infected with trich show no symptoms and are completely unaware of having the infection until randomly tested for STIs. 

When women do experience symptoms associated with trichomoniasis, they typically manifest within 28 days of infection and present as follows:

  • Vaginal itching 
  • Redness & swelling around the vaginal opening & vulva
  • Milky white, yellow, or green vaginal discharge with an unpleasant mildewy smell
  • Frequent urge to urinate
  • Burning sensation when urinating
  • Spotting or light bleeding, particularly after intercourse
  • Pain in the lower abdomen 

Causes of Trichomoniasis? 

Trichomoniasis is caused by a parasite called Trichomonas Vaginalisas (TV) which is passed from one partner to another during unprotected sex. Because trichomoniasis is symptomless for most men, many women do not know they have been infected until the first signs of vaginitis occur. 

Treating Trichomoniasis

Once your doctor has diagnosed trichomoniasis, an antibiotic will be prescribed to treat it. It is vital to complete the course of antibiotics to kill the parasite causing the infection and to let your sexual partner(s) know that you have been infected so that they can seek treatment too. It is equally as important that your partners inform any additional sexual partners they may have to ensure that you don’t get infected again. 

It is also recommended to abstain from alcohol and any sexual activity while completing your course of antibiotics for trich. A follow-up exam, approximately three months after treatment is usually advised to ensure TV has been eliminated from the body. To prevent contracting trich again, use contraception with all sexual partners, both male & female, and clean all sex toys thoroughly after use. 

4. Viral Vaginitis: What Is It?

In addition to bacteria, fungi, and parasites, viruses are another common cause of vaginitis, most of which are passed on during sexual activity. Herpes, otherwise known as the Herpes Simplex Virus (HSV) and papillomavirus (HPV) are two of the most common sexually transmitted viruses. 

Herpes symptoms include pain in and around the vagina as well as abrasions and blisters on the outer genitals that can sometimes occur on the inner vaginal walls too. HPV is known to result in warts on the groin, rectum, vagina, and vulva that are sometimes visible and sometimes not. If left untreated, HPV is considered the most common cause of cervical cancer due to the changes that take place in the cells over time. 

Treatment for Viral Vaginitis

No cure for genital herpes currently exists, but antiviral medication is helpful to prevent or curtail outbreaks as well as lessen the risk of passing it on to others.  

HPV vaccination is recommended by the CDC for both young males and females as early as the age of 9 to prevent infection later in life. Women who did not receive the vaccination when they were younger can still get vaccinated up to the age of 45 but with the understanding that it will not provide as much protection. 

If HPV is contracted later in life, vaccination will not cure the infection, however, treatments are available for precancerous cell changes caused by HPV. These treatments include topical medicines to treat lesions and sores, surgical excision, cryosurgery, laser therapy, and the loop electrosurgical excision procedure (LEEP) to remove abnormal tissue.  

5. Noninfectious Vaginitis: What Is it?

Noninfectious vaginitis normally occurs due to an allergic reaction or skin sensitivity to products such as douches, fragranced menstrual products, scented soaps, or detergents. It can also be triggered by hormone fluctuations due to menopause, radiation therapy, a hysterectomy, removal of the ovaries, or during breastfeeding.

This type of vaginitis is referred to as Atrophic Vaginitis and is typically caused by a drop in estrogen. 

Symptoms of noninfectious vaginitis include:

  • Vaginal itching
  • Vaginal burning 
  • Pain during sex

Symptoms associated with vaginal atrophy are often limited to a sensation of vaginal dryness and pain during intercourse, but for a large proportion of women symptoms also include urinary issues and light spotting. 

Below, we’ve compiled an extensive list of all symptoms known to be associated with vaginal atrophy. However, bear in mind that not all women will experience all symptoms. 

  • Vaginal dryness
  • Feeling of tightness in the vaginal canal
  • Painful intercourse (dyspareunia)
  • Light bleeding after sex
  • Less pubic hair
  • Thinning of the vulva & labia
  • Genital itching
  • Yellow or grey vaginal discharge
  • Vaginal irritation while riding a bike
  • Vaginal irritation when wearing tight pants 
  • Burning feeling when urinating
  • More frequent urge to urinate
  • Urinary incontinence
  • Recurring urinary tract infections (UTIs)

Treating Noninfectious Vaginitis

Treatment for noninfectious vaginitis depends on what the irritant is. You might have to run through a process of elimination with any new hygiene products or detergents used before the vaginitis occurred, but once you stop using whatever product it is, symptoms of vaginitis will generally disappear.

An organic moisturizer, like Enchanted Rose Natural Vaginal Moisturizer, will help to relieve itching and irritation. 

Treating Atrophic Vaginitis

If painful sex (dyspareunia) is the only symptom caused by vaginal atrophy, using an organically-made water-based lubricant during sexual activity helps to relieve discomfort. If you suffer from more of the symptoms listed above, speak with your doctor about additional treatment options for vaginitis associated with vaginal dryness. 

Hormone replacement therapy is a medical solution that certainly works for some in relieving vaginal dryness, however, it also has some grave side effects for others. Alternative therapies including Pelvic Floor Physical Therapy and the use of vaginal dilators at home have proven incredibly successful to relieve dryness and reignite sexual pleasure for women after menopause.

Regular exercise helps to improve blood circulation within the genital tissues. And organic vulvar balms & genital moisturizers come highly recommended to hydrate dry vaginal skin.   

Conclusion

Vaginitis refers to any type of inflammation or irritation of the vagina with symptoms varying in severity depending on the root cause. Unfortunately, many women avoid seeking treatment for vaginitis due to embarrassment, even though it is easily treated.

If you can relate to any of the types of vaginitis mentioned above, schedule an appointment with your healthcare practitioner for a proper diagnosis and treatment options. 

References 

Johns Hopkins Medicine – Vaginitis - https://www.hopkinsmedicine.org/health/conditions-and-diseases/vaginitis

Centers For Disease Control & Prevention – Bacterial Vaginosis - https://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm

Cleveland Clinic – Boric Acid Suppository - https://my.clevelandclinic.org/health/drugs/19641-boric-acid-vaginal-suppository

National Center for Biotechnology Information – Clinicians' use of Intravaginal Boric Acid Maintenance Therapy for Recurrent Vulvovaginal Candidiasis and Bacterial Vaginosis - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6878170/

Centers for Disease Control & Prevention – Trichomonasias CDC Fact Sheet

https://www.cdc.gov/std/trichomonas/stdfact-trichomoniasis.htm

Centers for Disease Control & Prevention – Genital Herpes Treatment and Care -  https://www.cdc.gov/std/herpes/treatment.htm

National Cancer Institute – HPV and Cancer - https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer

Mayo Clinic - Vaginal Atrophy - https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288

American Family Physician - Diagnosis and Treatment of Atrophic Vaginitis - https://www.aafp.org/pubs/afp/issues/2000/0515/p3090.html

The Pelvic Hub – Why Use Dilators for Atrophy - https://www.thepelvichub.com/ask-the-experts/dilators-for-atrophy