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Inflammation inside vagina also referred to as vaginitis can cause itching, discomfort and discharge. When your vagina and vulva are both inflamed, it’s known as vulvovaginitis.
It normally results from an infection. The patient typically has a discharge, itching, burning, and possibly pain. It is a common condition, and most women will have it at least once at some time in their life.
The most common symptoms include but not limited to:
- Irritation of the genital area or itching
- Discharge that may be white, grey, watery, or foamy
- Inflammation, leading to redness and swelling of the labia majora, labia minora, and perineal area, mainly due to an excess of immune cells
- Dysuria, which is pain or discomfort when urinating
- Painful sexual intercourse, known as dyspareunia
- Foul or fishy vaginal odour
- Light bleeding or spotting
There are several types of vaginitis, depending on the cause.
The most common are:
- Atrophic vaginitis: The endothelium, or lining of the vagina, gets thinner when estrogen levels decrease during the menopause, making it more prone to irritation and inflammation.
- Bacterial vaginosis: This results from an overgrowth of normal bacteria in the vagina. Patients usually have low levels of normal vaginal bacteria called lactobacilli.
- Trichomonas vaginalis: Sometimes referred to as trich, it is caused by a sexually transmitted, single-celled protozoan parasite, Trichomonas vaginalis. It may infect other parts of the urogenital tract, including the urethra, where urine leaves the body.
- Candida albicans: A yeast that causes a fungal infection, known as vaginal thrush. Candida exists in small amounts in the gut and is normally kept in check by normal gut bacteria. 2
Vaginitis can be caused by any of the following infections or irritants:
- Thrush – a common yeast infection that affects most women at some point
A yeast infection of the vagina and tissues at the opening of the vagina(vulva).Symptoms may include
- Vaginal discharge
- Itching of vagina
- Bacterial vaginosis – a bacterial infection where the balance of bacteria inside the vagina is disrupted
- Trichomoniasis – an STI caused by a tiny parasite
- chemical irritation – for example, from perfumed soap, bubble bath, or fabric conditioner, or from spermicide (a chemical that kills sperm, sometimes used on condoms) and some sanitary products
- washing inside your vagina
- Chlamydia – an STI caused by bacteria
- Gonorrhoea – an STI caused by bacteria
- Genital herpes – an STI caused by the herpes simplex virus 1
Some of these factors may 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 to vaginitis. 3
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 a woman is pregnant, she should make sure her doctor knows, because vaginitis can affect the fetus and because some treatment options may not be suitable. 4
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
- practising sex with a condom
- using antibiotics only when necessary 5
The common and general prevention is by good hygiene.