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Vaginitis - Vaginitis (yeast infection, BV, Trich)

What is Vaginitis?

Vaginitis is an inflammation, infection or change in normal flora (good bacteria) of the vagina and the vulva that may cause pain, itching and discharge. Vaginitis is very common. Three types of vaginitis occur most frequently:

  1. Bacterial Vaginosis (BV)
  2. Yeast (Candida) Infections
  3. Trichomonas Infections

Although these vaginal infections have many common symptoms, each is caused by a different organism and is treated in different ways. The specific organism is determined through a microscopic examination of the vaginal discharge. A pelvic exam and history of your symptoms will help to identify which vaginitis is present, if any. It is possible for more than one type of vaginal infection to be present at the same time. Women who have BV or trichomonas are more susceptible to sexually transmitted infections (STI’s) like chlamydia.

All women normally have vaginal discharge. It will usually look transparent or cloudy-white and somewhat filmy. When it dries on clothing it is yellowish. Generally, the discharge has little odor and causes no irritation. Normal vaginal discharge is made of mucus secretions from the cervix and vagina plus discarded vaginal cells.

The amount of discharge varies according to the time of a woman’s menstrual cycle, medications, diet, stress and her state of sexual arousal.

If the delicate balance in the vagina is upset, organisms normally present in the vagina can multiply at a higher rate than normal. Also, the imbalance may make the vagina more susceptible to “invader” organisms which would normally be controlled as they entered the vagina. The organisms (bacteria, fungi or protozoa) create waste products which can irritate tissue, cause a change in discharge, an unpleasant odor, itching, burning, redness, painful sex or urination, spotting and/or swelling. If you have these symptoms, you should have an exam to see if you need treatment.

Bacterial Vaginosis “BV”

Is caused by an overgrowth of vaginal bacteria from a change in the normal acid environment of the vagina. This infection may occur spontaneously or be related to sexual activity. Things that can upset the balance of natural bacteria can include having a new sexual partner, male ejaculate in vagina, multiple partners or hygienic products. The discharge may be thick or watery and may have an unpleasant odor, often more noticeable after intercourse. Some women note pain or burning with intercourse or urination but rarely have itching or redness. Some do not report symptoms at all. There are different treatments now available, including oral or vaginal medications. Treatment of male sex partners is not recommended because it has not been beneficial in preventing the recurrence of BV. Using condoms with each sex act may prevent future infections. Women with female sexual partners who have BV are at risk due to vaginal fluid transmission.

Yeast (Candidiasis) Infection

This fungal organism is normally present, in small and harmless quantities, in the mouth, digestive tract, and vagina. When the balance in the vagina is upset (sometimes from taking antibiotics recently) and yeast overgrows, you may notice symptoms: itching, burning, redness or swelling around the vaginal opening. Discharge is usually white and thick or clumpy. Yeast infections are not usually sexually transmitted.

Yeast infections are usually treated with vaginal creams or suppositories available “over-the-counter” without a prescription. Typically using a 3 day treatment will cure your infection more often than a 1 day treatment. Sometimes prescription creams or tablets are prescribed.

Trichomonas Infection

This condition is caused by a one-celled organism (trichomonas vaginalis) generally called “trich” (pronounced “trick”). It may be found in both men and women and can be transmitted sexually. Women who have trich may have a thin but foamy discharge which is greenish or grayish in color with an unpleasant odor. Itching, redness, pain and frequent urination may also occur. An oral antibiotic is the usual treatment. All sex partners should be treated and you should not have sex until treatment is completed. You should be tested for other STI’s.

More on Treatment

It is important to use the medication exactly as it is prescribed. Do not stop using medication when symptoms disappear as some organisms may survive incomplete treatment. Avoid sexual intercourse during the treatment. This will allow irritated vaginal tissue to heal faster. If you do have intercourse, use a condom & water based lubricant (KY Jelly, Astro-glide, etc.). However, some vaginal medications may weaken the latex in condoms, causing possible breakage.

Prevention of Vaginitis:

Vaginal infections thrive in moisture and warmth. Keep the vaginal area (vulva) as dry as possible. Consider the following suggestions:

  • Dry carefully after bathing.
  • Avoid frequently wearing leggings, spandex and tight clothing that doesn’t “breathe” well
  • Wear cotton underwear and don’t use fabric softener on underwear.
  • Do not sleep in underwear.
  • Do not douche.
  • Change out of a wet bathing suit or wet clothing immediately after swimming or exercising.
  • Avoid hot tubs or hot baths.
  • Avoid deodorant or scented pads or tampons.
  • Avoid scented soaps or body wash in genital area; use mild, unscented soaps. Rinse genitals after a bubble bath.

There is NO evidence from randomized trials that taking supplements of lactobacillus, garlic, tea tree oil, probiotics or eating yogurt with acidophilus are helpful. Some women notice eating less sugar has helped avoid frequent candidiasis.

If your symptoms don’t get better after treatment, call 812-855-7688 for a medical appointment. If you have questions about vaginitis or other health care concerns call Health and Wellness Education at 812-855-7338.


Title 7/18/2018

Content 5/25/2018