[ Vaginitis ]

What is Vaginitis?

Vaginitis is an inflammation of the vagina associated with discharge, foul odor, swelling, burning, irritation, or infection. Vaginitis is so common that most women have it at least once in their lives. There are many different germs which cause vaginitis, but the most common are bacterial vaginosis (BV), trichomoniasis (caused by a parasite called Trichomonas vaginalis), and vaginal yeast infection or candidiasis.

Bacterial vaginosis (BV), associated with sexual activity, is the most common cause of vaginitis. BV reflects a change in the Lactobacillus bacteria, the “good” bacteria and the “bad” bacteria. Instead of the Lactobacillus bacteria being most numerous, the “bad” bacteria, which could be Gardnerella vaginitis, Bacteroides, Mobiluncus, or Mycoplasma, grows too fast and causes infections.

Trichomoniasis is mainly an infection of the urogenital tract. The uretha is the most common site of infection in men and the vagina is the women’s most common site.

Vaginitis may be transmitted through sexual contact, but may not, depending on the cause, as in yeast infections. The imbalance may occur due to medicines such as antibiotics, damp underwear, douching, lubricants, sprays, birth control devices, tight, poorly ventilated clothing, pregnancy, oral contraceptives, and poor nutrition. Yeast is always present vaginally in small numbers and symptoms only appear with its overgrowth.

Symptoms

Some women are unaware of their BV infection because they have mild cases, almost half with clinical signs don’t report symptoms. The primary symptom of BV is an abnormal discharge with a fish-like odor, especially after sexual intercourse.

Symptoms of vaginitis due to trichomoniasis in women are a green, yellow or grey discharge, a foul odor, painful intercourse, painful urination, or itching in or around the genital area. Men usually don’t have any symptoms, but if present, include painful urination and a whitish discharge from the penis.

Signs of a yeast infection are thick, white discharge, pain, itching, burning or redness around the vagina, or a smell like baking bread. Most male sex partners of women with yeast infections don’t experience any symptoms.

Treatment

BV is treated with antibiotics such as metronidazole and clindamycin. Male sex partners are not usually treated.

In order to eliminate the parasite, both sex partners should be treated for trichomoniasis, even though the male is usually asymptomatic. Metronidazole is usually the antibiotic used.

There are many antifungal vaginal medications that treat yeast infections: butoconazole, clotrimazole, miconazol, tioconazole, and terconazole. Women can purchase some products over the counter, but it is suggested that they see their physician for accurate diagnosis.

Testing

A healthcare provider can determine the presence of organisms producing BV by examining a sample of vaginal fluid under a microscope. They can make a diagnosis based on the presence of numerous “clue cells”, absence of lactobacilli, decreased acidity of the vaginal fluid, and a fish-like odor.

A sample of the discharge can also be examined under a microscope by a healthcare provider to diagnose trichomoniasis and yeast infections.