The vagina is an amazing self-cleaning, self-lubricating, tubular muscle (a.k.a. the birth canal), but when something is not quite right, you notice pain, itching, discharge, or odor, one of the most common reasons is a group of conditions called“vaginitis.”

‍

‍

What is vaginitis?

Vaginitis refers to inflammation or infection of the vagina. Symptoms can range from very mild to severe and can include vaginal itching, irritation, discharge, or vaginal odor. 

‍

The most common infectious causes include yeast (candida), bacterial vaginosis (from a group of bacterial overgrowth), and sexually transmitted infections (e.g., gonorrhea, chlamydia, herpes, trichomonas).   

‍

You can also have non-infectious vaginitis from exposure to allergens/irritants or with the lower estrogen changes of menopause.

‍

Who is more likely to get vaginitis?

You may have an increased risk of getting vaginal infections if you have an altered immune system (ie. HIV, poorly controlled diabetes), a shift in normal vaginal flora (ie. after using antibiotics), hormonal changes (ie pregnancy, menopause), exposure from a partner (for those types transmitted sexually),  or a change in personal hygiene.

‍

‍

What are the symptoms and treatments of vaginitis?

‍

Infectious types: 

‍

Bacterial vaginosis - an overgrowth of several different bacteria 

• Symptoms: thin/watery, white/green/gray vaginal discharge, irritation, fishy odor
• Treatment: antibiotic pills by mouth or a gel/cream you apply to the vaginal area

‍

Yeast infection - overgrowth of yeast, usually Candida albicans (less commonly Candida glabrata)

• Symptoms: thick, white, vaginal discharge, itching, redness of vulvovaginal area‍
• Treatment: antifungal pills by mouth or a cream/insert applied directly to the vaginal area

‍

Trichomonas - a parasite from a sex partner (men often have no symptoms)

• Symptoms: frothy, green/yellow discharge, irritation, itching‍
• Treatment: antibiotic pills by mouth

‍

Herpes - a virus (type 1 or 2 ) from skin-to-skin contact with a sex partner

• Symptoms: blisters → ulcers, pain, itching‍
• Treatment: antiviral pills by mouth, taken if you have an outbreak, or also taken daily to prevent outbreaks

‍

Gonorrhea / Chlamydia - bacteria from exposure to an infected sex partner

• Symptoms: you may have no symptoms or you can have vaginal discharge, vaginal irritation, abdominal pain, and/or pain with sex.‍
• Treatment: antibiotics by mouth

‍

‍

Non-infectious types:

‍

Allergens/irritants - usually from exposure to products used in the vaginal area such as spermicide, douches, pads, perfumes, scented soaps, or fabric softeners.  

• Symptoms: irritation, itching, odorless discharge‍
• Treatment: avoid irritants, topical steroid cream applied to the vaginal area, or antihistamines

‍

Low estrogen states - perimenopause/ postmenopause or postpartum 

• Symptoms: vaginal dryness, itching, pain with intercourse‍
• Treatment: vaginal moisturizers, lubricants, or estrogen cream/inserts applied to the vaginal area

‍

‍

What can I do to stay healthy down there? 

• Practice good vaginal hygiene 
• Wipe front to back
• Wash the vagina with water only, gentle unscented soap if needed
• Avoid scented soaps/detergents/pads/dryer sheets
• Avoid douching
• Wear breathable underwear (cotton)
• Change out of wet workout clothes/swimwear ASAP
• Use condoms each time you have sexual intercourse to help reduce the risk of getting a sexually transmitted infection or disease (STI/STD)
• Urinate after sexual intercourse - this flushes out the urethra (the tube from the bladder), reducing bacterial exposure.
• Treat vaginal dryness related to low estrogen with lubricants, moisturizers, or topical estrogen therapy.

‍