Vaginitis is an inflammation of the vaginal wall that results from vaginal irritation or infection. It often causes a change in the color, consistency and scent of normal vaginal secretions and may be accompanied by vaginal discomfort and itching. Vaginitis is a common condition that occurs in many women. It is generally not serious and is easily treated. Normal vaginal discharge is usually clear or white, odorless and nonirritating. All women have some vaginal discharge which may vary in amount and consistency according to the time of the menstrual cycle.

Possible Causes of Irritation

Vaginal irritation can be caused by:

• Chemicals in commercial douches or vaginal sprays that destroy the vagina’s natural protective environment. Some women may also be sensitive to certain spermicides.
• Trauma to the vaginal wall, including abrasions that occur as a result of having sexual intercourse without sufficient vaginal lubrication. Tight fitting clothing and some sanitary pads may also cause irritation.
• A variety of organisms, including some which are “resident” members of the vaginal environment and others that may be contracted through sexual intercourse with an infected partner.

The vagina of a healthy woman contains a variety of “resident” organisms that live together in balanced harmony. Certain conditions can upset this delicate equilibrium causing an imbalance to occur. This produces a vaginal discharge which is often irritating and may have a scent and appearance that is different from the natural colorless, odorless secretions that normally keep the vagina moist and clean. Conditions that may upset this delicate balance include:

• Pregnancy
• Oral contraceptives
• Diabetes
• Some antibiotics
• Any physical or emotional stressor that lowers a woman’s immune system and her resistance to infection.

Types

Yeast, Monilia, or Candida

This is a resident organism that commonly overgrows as a result of the factors previously mentioned. It often creates a cottage cheese-like vaginal discharge which causes vaginal itching, burning, swelling, or soreness.

This infection can be easily treated with an oral, one dose medication or a specific vaginal medication that is inserted into the vagina at bedtime so that it can flow throughout the vagina and provide healing relief. These medications can be purchased at any pharmacy or prescribed by a health professional. They must be used the full number of nights directed, even if a woman is having her menstrual period. During the time the medication is being used, a woman should not use tampons. She will, however, need a panty liner during the day to absorb any excess medication that might seep from the vagina. If symptoms persist, medical evaluation should be sought.

Bacterial Vaginosis (BV)

This vaginal infection may be caused by an overgrowth of bacteria that normally live in the vagina. Possibly bacteria may be displaced from the anal area into the vagina during sexual intercourse or by wiping from back to front after urinating or passing stool. The exact cause is unknown. It may be transmitted through sexual intercourse with an infected partner, however, it can be found in women who are not sexually active. In women, this organism produces a vaginal discharge that is creamy white or greyish in color and has a fish-like odor. Men typically have no symptoms. Treatment consists of vaginal creams, suppositories, or oral antibiotics such as flagyl (see Trichomoniasis).

Trichomoniasis or “Trich”

This organism is a single-celled parasite which is often transmitted through sexual intercourse with an infected partner. It rarely can also be contracted through the use of moist towels, washcloths, or bathing suits used by an infected person. In women, it usually produces a yellowish-green foamy discharge that results in vaginal itching. Most men have no apparent symptoms. Even if only one partner has symptoms, all partners must be treated simultaneously to prevent reinfection.

The most common and effective treatment for trichomoniasis is a medication called Flagyl, which is available in a vaginal gel or in a pill form and prescribed by a health care professional. Flagyl may cause an unpleasant metallic taste in the mouth. In addition, persons taking Flagyl are cautioned not to drink alcohol which, in combination with Flagyl, may result in vomiting. Other possible side effects of Flagyl include dizziness, loss of coordination, confusion, irritability, or the appearance of a rash. If any of these symptoms occur, stop taking this medication and seek medical evaluation immediately.

Treatment

Regardless of the type of vaginitis one develops, the following guidelines can assist in the treatment of a current problem and in the prevention of recurrent vaginal infections.

• Take all prescribed medicine according to directions, even if symptoms seem to disappear and you are “getting better.”
• If symptoms are still present after all medication has been taken according to directions, make an appointment for an examination with your health care professional.
• Wear cotton-lined underpants that allow air to circulate to the vaginal area. Avoid tight pants and clothes that restrict this movement of air.
• Avoid using another person’s soap, towel, washcloth, or bathing suit.
• Use appropriate feminine hygiene, always washing or wiping from front to back to avoid bringing any organisms forward from the rectal area to the vaginal opening.
• If you choose to engage in vaginal or anal intercourse, always use spermicidally lubricated condoms, even if you are taking oral contraceptives to prevent pregnancy. If you engage in anal intercourse, the vagina should not be entered after rectal penetration. Wash after intercourse.
• Use adequate lubrication during intercourse. Inadequate lubrication may cause trauma to the vagina and make it more vulnerable to infection. Most young women produce sufficient sexual lubrication if they have a considerate sexual partner who takes time with love-making to ensure sexual arousal. If additional lubrication is desired, a water-soluble lubricant or spermicidal lubricant containing nonoxynol-9 are the best choices. Do not use vaseline.
• Do not douche unless this has been prescribed by a health care professional to aid in the treatment of an infection. Douching washes away the natural protective secretions of the vagina and may make a woman more susceptible to vaginal and pelvic infections.
• Do not use vaginal sprays, perfumed soaps or deodorant tampons. Appropriate feminine hygiene consists of washing with a mild soap and water from front to back at least once a day. Other products may be injurious to delicate vaginal tissue.