Experiencing abnormal vaginal discharge, odor, itching, burning or discomfort? These are classic symptoms of vaginitis, which is the medical term for “inflammation of the vagina” resulting in the uncomfortable symptoms listed above. Vaginitis is experienced by 1 in 3 women at some point in their life, making it the most common gynecologic diagnosis seen in primary care and definitely something that is important to talk about!
Vaginitis can be caused by infections, decreased estrogen (after menopause), allergic/irritant sensitivities to products or autoimmune conditions. Infections include bacterial vaginosis (BV), candidiasis (yeast), or sexually transmitted infections (chlamydia, gonorrhea, trichomonas). BV is the most common cause of vaginitis, making up 40-50% of cases and yeast infections account for 20-25%. Non infectious forms include atrophic (low estrogen in menopause), irritant or allergic, and inflammatory (autoimmune) vaginitis. These make up 5-10% of vaginitis cases.
Symptoms can be very uncomfortable and include abnormal discharge, odor, itching, burning, discomfort or pain with sex. Each cause has a “classic” presentation, for example, BV classically causes thin green discharge, vaginal discomfort and foul odor while yeast infections often cause thick white chunky discharge and vaginal itching. But this is not always the case and why it is important to always see your healthcare provider.
A diagnosis for infectious vaginitis is most commonly made with a vaginal swab that can be done by the provider or the patient, both with similar accuracy. It is important to express if you have any concern for sexually transmitted infections so those can be tested for too. Non infectious causes of vaginitis are diagnosed by history and exam findings.
Time to talk treatment! Infectious causes are treated with a variety of antibiotics and/or anti-fungals. It is also important to remove triggers that may be precipitating symptoms such as fragrance soaps, douches, etc. If symptoms continue to recur, there are longer courses of antibiotics or anti-fungals that can be prescribed to prevent recurrence. Atrophic vaginitis is caused by low estrogen, typically in menopause, and can be treated with topical estrogen creams.
Vaginitis can be a very uncomfortable, physically and psychologically and it may be difficult to speak about. It is important to seek care from a trusted healthcare professional if you feel you may be experiencing vaginitis.
Reference:
1.Paladine HL, Desai UA. Vaginitis: Diagnosis and Treatment. American Family Physician. 2018;97(5):321-329. https://www.aafp.org/pubs/afp/issues/2018/0301/p321.html
