Vaginitis: symptoms, causes and treatment

Inflammation of the vagina can be caused by many different conditions. Find out more about the causes and the treatments available.

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Vaginitis is an inflammation of the vagina, which can result in soreness and swelling. It can also cause itchiness, pain and discharge.

The commonest causes of vaginitis are infections. However, sometimes allergies to products such as soap or perfume, or to the rubber in some condoms, can be responsible.

Vaginitis symptoms

There are some possible symptoms of vaginitis (which may also occur in other conditions):

  • A change in discharge, both in smell and colour.
  • Vaginal dryness in some cases.
  • An itching, burning or simply sore sensation in the vagina.
  • Discomfort when passing water, or during sex.
  • Light vaginal bleeding or spotting when you would not expect it
  • Cracked, swollen or sore skin around the vagina

    Vaginitis causes

    What causes vaginitis? Vaginitis can be caused by many different types of organism, although the symptoms tend to be similar.

    If it is caused by irritation from perfumed cleansers or soaps, tampons, particular type of condom and so on, you would expect it to resolve more easily on its own when you change use to a different product. Washing the perineal area with a simple unperfumed soap or water and avoiding douches is better to keep the vaginal pH and natural bacteria in a healthy balance. The most common causes of vaginitis are described below.

    Thrush

    Thrush infection caused by overgrowth of a fungus (candida albicans) is the most common cause of vaginitis and is a cause of irritation for many women.

    Symptoms are itching in the crotch area and vagina, but increased discharge is not necessarily present. If there is increased discharge it is often white and lumpy.



    Other causes

    Your risk of developing fungal infections increases if you:

    • have diabetes
    • are pregnant
    • are on the contraceptive pill (do not just stop the pill – consult your nurse or doctor)
    • have a defective immune system.

      Fungus in the vagina is almost always caused by a change in the vagina's acid balance, which leads to an increase in fungus growth. Fungus is often seen after taking antibiotics.

      There is not always an obvious reason why a woman has a thrush infection. Many women recognise the symptoms themselves and obtain over the counter treatment from the chemist. This can be as a cream, pessary or tablet. If you take a tablet discuss any other medication you are on with your pharmacist. If you're uncertain whether it is thrush, you should see your doctor or nurse. In many cases you can infect your partner so wait to have sex until the symptoms have resolved.

      Diagnosis is straightforward and can be confirmed by taking a swab (like a cotton bud that the doctor or nurse gently uses to take a sample of fluid from the vaginal area or skin wall) from the vagina. Treatment is either with pessaries (tablets in the vagina) or tablets by mouth.



      Trichomonas

      Trichomonas is caused by a small organism called a flagellate. It is common to experience an abundant greenish-yellow discharge, an itching, burning sensation, or pain in the vagina.

      Diagnosis is performed by analysing a swab of the discharge. Treatment is a short course of antibiotics.

      Bacterial vaginosis

      Gardnerella vaginalis (bacterial vaginosis) is caused by the growth of bacteria that causes the acidity of the vagina to become more alkaline. It commonly causes a greyish, foamy discharge with a fishlike smell.

      Diagnosis is carried out by analysing a swab from the discharge. Treatment is a short course of antibiotics.



      Gonorrhoea

      Gonorrhoea is caused by the gonococcus bacteria, and is only transmitted sexually.

      Gonorrhoea can be present without any symptoms, but some people have burning pain when urinating. However, gonorrhoea is rarely seen these days.

      Diagnosis is confirmed by analysing a swab from the cervix, urethra (entrance to the bladder) or back passage. Treatment is with antibiotics.

      Sexual partners should also be traced, tested for gonorrhoea and treated.



      Chlamydia

      Chlamydia is an unusual cause of vaginitis, since infection often does not produce symptoms unless pelvic inflammatory disease is present. Chlamydia is a sexually transmitted disease (STD). Chlamydia needs to be treated as untreated it can go on to affect fertility in some cases.

      Diagnosis is made by analysing a sample taken from the cervix or the urethra. Treatment is with antibiotics.

      Sexual partners should be traced, tested and treated.



      Herpes

      Herpes is caused by the herpes simplex virus and is usually a sexually transmitted disease.

      It is possible to infect the genital area with the virus via contact with a cold sore (the viruses are part of the same family). Herpes is seen at the entrance to the vagina as small blisters.

      The first time a person has herpes, fever is common, general discomfort is experienced, urination is painful, and the lips and entrance to the vagina are swollen and red.

      Diagnosis is made by a doctor based on the appearance and with special swabs sent for analysis. Antiviral treatment is often recommended.

      Unfortunately, herpes infections often return, although the symptoms are usually less severe.



      When to consult a doctor

      If you are concerned about vaginal discharge or vaginitis – especially if there is a possibility it may be an STD, you should seek advice from your GP, Family Planning Clinic, genitourinary medicine (GUM) clinic or gynaecologist.

      See a Doctor or Nurse or go to a sexual health clinic if:

      • you have symptoms of vaginitis for the first time and it is uncomfortable and does not seem to be like simple thrush
      • this episode of vaginitis is a lot worse or different to before and not getting better
      • you have new discharge that is unusual for you
      • you have symptoms of vaginitis after unprotected sex with a new partner
      • you have other symptoms with it, like feeling unwell, shivery, hot or pain in your tummy or pelvis area

        Do not have sex until you have seen a clinician in case you have a sexually transmitted infection.


        Last updated: 22-04-2020

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