Gynecologic Problems
FAQ028, August 2011



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Vaginitis

What is vaginitis?

Vaginitis is an inflammation of the vagina. As many as one third of women will have symptoms of vaginitis sometime during their lives. Vaginitis affects women of all ages but is most common during the reproductive years.

What can cause vaginitis?

A change in the balance of the yeast and bacteria that normally live in the vagina can result in vaginitis. This causes the lining of the vagina to become inflamed. Factors that can change the normal balance of the vagina include the following:

  • Use of antibiotics
  • Changes in hormone levels due to pregnancy, breastfeeding, or menopause
  • Douching
  • Spermicides
  • Sexual intercourse
  • Infection

How is vaginitis diagnosed?

To diagnose vaginitis, your health care provider will take a sample of the discharge from your vagina and look at it under a microscope. Your health care provider also may suggest other tests.

How is vaginitis treated?

Treatment will depend on the cause of the vaginitis. Treatment may be either with a pill or a cream or gel that is applied to the vagina.

What is a yeast infection?

Yeast infection also is known as candidiasis. It is one of the most common types of vaginal infection.

What causes yeast infections?

A yeast infection is caused by a fungus called Candida. It is found in small numbers in the normal vagina. However, when the balance of bacteria and yeast in the vagina is altered, the yeast may overgrow and cause symptoms.

What factors increase the risk of getting a yeast infection?

Use of some types of antibiotics increase your risk of a yeast infection. The antibiotics kill normal vaginal bacteria, which keep yeast in check. The yeast can then overgrow. A woman is more likely to get yeast infections if she is pregnant or has diabetes. Overgrowth of yeast also can occur if the body’s immune system, which protects the body from disease, is not working well.

What are the symptoms of a yeast infection?

The most common symptoms of a yeast infection are itching and burning of the area outside the vagina called the vulva. The vulva may be red and swollen. The vaginal discharge usually is white, lumpy, and has no odor. Some women with yeast infections notice an increase or change in discharge.

What treatments are available for vaginal yeast infection?

Yeast infections can be treated either by placing medication into the vagina or by taking a pill.

Should I use an over-the-counter medication to treat a yeast infection?

Over-the-counter treatments are safe and often effective in treating yeast infections. But many women think that they have a yeast infection when they actually have another problem. In these cases, a medication for a yeast infection will not work and may cause a delay in proper diagnosis and treatment of the actual problem.

Even if you have had a yeast infection before, it may be a good idea to call your health care provider before using an over-the-counter medication to treat your symptoms. If this is the first time you have had vaginal symptoms, you should see your health care provider. If you have used an over-the-counter medication and your symptoms do not go away, see your health care provider.

What is bacterial vaginosis?

Bacterial vaginosis is caused by overgrowth of the bacteria that occur natually in the vagina.

What are the symptoms of bacterial vaginosis?

The main symptom is increased discharge with a strong fishy odor. The discharge usually is thin and dark or dull gray, but may have a greenish color. Itching is not common, but may be present if there is a lot of discharge.

How is bacterial vaginosis treated?

Several different antibiotics can be used to treat bacterial vaginosis, but the two that are most commonly used are metronidazole and clindamycin. They can be taken by mouth or inserted into the vagina as a cream or gel.

What is trichomoniasis?

Trichomoniasis is a condition caused by the microscopic parasite Trichomonas vaginalis. It is spread through sex. Women who have trichomoniasis are at an increased risk of infection with other STDs.

What are the symptoms of trichomoniasis?

Signs of trichomoniasis may include a yellow-gray or green vaginal discharge. The discharge may have a fishy odor. There may be burning, irritation, redness, and swelling of the vulva. Sometimes there is pain during urination.

How is trichomoniasis treated?

Trichomoniasis usually is treated with a single dose of metronidazole by mouth. Do not drink alcohol for 24 hours after taking this drug because it causes nausea and vomiting. Sexual partners must be treated to prevent the infection from recurring.

What is atrophic vaginitis?

Atrophic vaginitis is not caused by an infection but can cause vaginal discharge and irritation, such as dryness, itching, and burning. This condition may occur any time when female hormone levels are low, such as during breastfeeding and after menopause. Atrophic vaginitis is treated with estrogen, which can be applied as a vaginal cream, ring, or tablet. A water-soluble lubricant also may be helpful during intercourse.

Glossary

Antibiotics: Drugs that treat infections.

Bacterial Vaginosis: A type of vaginal infection caused by the overgrowth of a number of organisms that are normally found in the vagina.

Candidiasis: Also called yeast infection or moniliasis, a type of vaginitis caused by the overgrowth of Candida (a fungus normally found in the vagina).

Clindamycin: An antibiotic used to treat, among other kinds of infections, certain types of vaginitis.

Estrogen: A female hormone produced by the ovaries that stimulates the growth of the lining of the uterus.

Hormones: Substances produced by the body to control the functions of various organs.

Menopause: The time in a woman’s life when the ovaries stop functioning; defined as the absence of menstrual periods for 1 year.

Metronidazole: An antibiotic used to treat some vaginal and abdominal infections.

Spermicides: Chemicals that inactivate sperm. They come in creams, gels, foams, and suppositories. Some condoms are coated with spermicides.

Trichomoniasis: A type of vaginal infection caused by a one-celled organism that is usually transmitted through sex.

Vulva: The external female genital area.

If you have further questions, contact your obstetrician–gynecologist.

FAQ028: Designed as an aid to patients, this document sets forth current information and opinions related to women’s health. The information does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to institution or type of practice, may be appropriate.

Copyright August 2011 by the American College of Obstetricians and Gynecologists. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.