Vaginitis: When to Worry and What to Do About It

Although it can be uncomfortable, it's not the end of the world.

Most women have been there. You're distracted and squirming in your chair because it doesn't feel right down there. Perhaps there's a smell that's a little, well, funkier, than usual. You want to do something to make it stop, now.

Although it can be darned uncomfortable, it's not the end of the world. You could have an infection caused by bacteria, yeast, or viruses.

It's not always easy to figure out what's going on, though. You'll probably need your doctor's help to sort it out and choose the right treatment.

Doctors refer to the various conditions that cause an infection or inflammation of the vagina as "vaginitis." Read on to learn more about these conditions and what you can do to relieve them.

The most common types

Vaginal inflammation is quite common, especially in women in their reproductive years. It usually happens when there is a change in the balance of bacteria or yeast that are normally found in your vagina. There are different types of vaginitis, and they have different causes, symptoms, and treatments.

When discharge has a very noticeable odor, or burns or itches, that's likely a problem. You might feel irritation at any time of the day, but it's most often bothersome at night. Having sex can make some symptoms worse.

Your vaginal discharge changes color, is heavier, or smells different. You notice itching, burning, swelling, or soreness around or outside of your vagina.

It burns when you pee. Sex is uncomfortable.

These are the most common signs you have vaginal inflammation, or vaginitis.

The most common types of vaginitis are:

  • Bacterial vaginosis, which results from a change of the normal bacteria found in your vagina to overgrowth of other organisms
  • Yeast infections, which are usually caused by a naturally occurring fungus called Candida albicans
  • Trichomoniasis, which is caused by a parasite and is commonly transmitted by sexual intercourse

How can you tell them apart?

How it feels – and why

With bacterial vaginosis, you may not have symptoms. You could have a thin white or gray vaginal discharge. There may be an odor, such as a strong fish-like odor, especially after sex.

Doctors report that bacterial vaginosis is the most common vaginal infection in women ages 15-44. It happens when there is an imbalance between the "good" and "harmful" bacteria that are normally found in a woman's vagina. Many things can change the balance of bacteria, including taking antibiotics, douching, using an intrauterine device (IUD), having unprotected sex with a new partner, or having many sexual partners.

Yeast infections produce a thick, white discharge from the vagina that can look like cottage cheese. The discharge can be watery and often has no smell. Yeast infections usually cause the vagina and vulva to become itchy and red.

Yeast infections (candidiasis) happen when too much candida grows in the vagina. Candida is the scientific name for yeast. It is a fungus that lives almost everywhere, including in your body. You may have too much growing in the vagina because of antibiotics, pregnancy, diabetes, especially if it is not well-controlled, or corticosteroid medicines.

Trichomoniasis can also cause vaginitis. You may not have symptoms when you have trichomoniasis. If you do have them, they include itching, burning, and soreness of the vagina and vulva. You may have burning during urination. You could also have gray-green discharge, which may smell bad.

Trichomoniasis is a common sexually transmitted disease. It is caused by a parasite.

If you can check for one or more of the above-mentioned symptoms, you should contact your doctor for a visit as soon as possible.

Rarely dangerous

The doctor will carry out a physical examination, ask about medical history, and may conduct a pelvic exam to check inside the vagina for inflammation and excess discharge. To find out the cause of your symptoms, your health care provider may study a sample of your vaginal fluid under a microscope. (In some cases, you may need more tests.)

The treatment depends on which type of vaginitis you have.

BV is treatable with antibiotics. You may get pills to swallow, or cream or gel that you put in your vagina. During treatment, you should use a condom during sex or not have sex at all.

Yeast infections are usually treated with a cream or with medicine that you put inside your vagina. You can buy over-the-counter treatments for yeast infections, but you need to be sure that you do have a yeast infection and not another type of vaginitis. See your health care provider if this is the first time you have had symptoms.

Even if you have had yeast infections before, it is a good idea to call your health care provider before using an over-the-counter treatment.

The treatment for trichomoniasis is usually a single-dose antibiotic. Both you and your partner(s) should be treated, to prevent spreading the infection to others and to keep from getting it again.

It is common for most women to have vaginitis at least once in their life, and it is rarely dangerous. Completing a course of doctor-prescribed medications will typically remove any infections and ease the related inflammation.

Not having sex and avoiding vaginal products containing potential irritants for several days after diagnosis may also speed up recovery.

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