The Facts About Vaginal Infections

If you've got a vagina, you'll probably experience vaginitis at some point in your life. It's simply irritation of your vagina or vulva. Vaginitis can happen when the chemical balance in your vagina changes, you pick up an infection or you react to a product.

Common causes of vaginitis include:

• Infections, such as bacterial vaginosis (BV), trichomoniasis and yeast infections
• An allergic reaction to intimate products, such as scented tampons or period pads, condoms, scented body washes, spermicide and scented lubricants
• Douching
• Irritation from tight clothing, washing powders, wearing a damp bathing suit or wet suit for an extended period, or chemicals in hot tubs and swimming pools
• Friction from sex or sex toy use
• A lack of estrogen
• Certain antibiotics

Let's look at the three most common types of infection that can lead to vaginitis:

Yeast infections

A fungus called Candida causes yeast infections, also known as candidiasis, which is extremely common. Yeast infections occur when there is an imbalance between the bacteria and yeast in the vagina, causing the yeast to overgrow. They are not sexually transmitted infections (STIs). This imbalance can happen when:

• Your hormones change, due to your menstrual cycle or pregnancy
• Your immune system is low
• You have diabetes
• You take certain antibiotics
• You have a reaction to another person's genital chemistry
• You have a condition that weakens the immune system, like HIV

Discharge from a yeast infection presents as thick, white and odorless. Some people say it looks like cottage cheese. On the other hand, you may not notice any change in your discharge and might have symptoms such as itching and burning of the vagina or vulva.

Bacterial vaginosis

When healthy bacteria get out of balance in your vagina, it can cause bacterial vaginosis. It's not an STI. Bacterial vaginosis usually causes an increase in vaginal discharge, which develops a strong fishy odor. Douching or using vaginal deodorants or other irritating products are the most common causes of bacterial vaginosis.

Trichomoniasis

Trichomoniasis is an STI caused by a tiny parasite called Trichomonas vaginalis. It has the same symptoms as other causes of vaginitis, but the vaginal discharge can be yellow-gray or green in color and have a fishy odor. Trich is an STI, so both you and your sexual partner need to be treated with antibiotics, and sex must be avoided until treatment is complete.

Vaginitis symptoms can differ depending on the cause. You might experience some or all of the following in the vulvar area and/or vagina:

• Itching or burning
• Pain
• Swelling
• Discoloration
• Pain or discomfort during sex or masturbation
• A change in your vaginal discharge that is different from normal
• Stinging when passing urine
• Increased need to urinate

Vaginitis isn't usually serious, but the symptoms can be very similar to a sexually transmitted infection, so if you have signs, it's always best to get checked out by a healthcare professional to make sure of the cause. You can see your nurse, doctor or OB-GYN or head to your local sexual health center.

To diagnose vaginitis, your healthcare provider takes a medical history and may also do a physical examination, take a urine sample or look at your vaginal discharge under a microscope.

The treatment of vaginitis depends on the root cause. Treatment modalities include:

• Oral antibiotics for trichomoniasis
• Oral antibiotics or gel/cream antibiotics to put on the vagina for bacterial vaginosis
• Creams, suppositories, vaginal tablets or oral pills to treat yeast infections
• Pinpointing something that has caused the irritation. If you know what caused it and stop using the product or doing the activity, the vaginitis will improve.
• Estrogen creams, pills or vaginal rings if the cause is low estrogen

Your healthcare provider can advise you on the best treatment depending on the cause, whether you're pregnant and the severity of your symptoms. If you have recurring yeast infections and know how to treat them, you can buy over-the-counter treatments from your pharmacy.

If you have a vaginal infection that isn't sexually transmitted, like a yeast infection or bacterial vaginosis, you can continue to have sex. However, it can be uncomfortable and make symptoms worse.

Trichomoniasis is sexually transmitted, so you have to refrain from sex until both you and your partner have completed the entire course of treatment as prescribed by your doctor.

There are several ways you can help prevent vaginitis:

• Avoid scented feminine hygiene products
• Do not douche; your vagina cleans itself
• Avoid strong soaps and detergents to clean the vulva; use plain, warm water 
• If you use a diaphragm, cervical caps or spermicide applicators, make sure you clean them and properly store them after use
• Use condoms to protect yourself from STIs
• Avoid sitting around in damp clothes, wet suits or bathing suits for too long
• Change tampons or period pads regularly
• Avoid spreading germs from your anus to your vagina. If you have put your fingers or sex toys in your anus, wash them before putting them in your vagina.
• If you have a latex allergy, use latex-free condoms
• Try using a lubricant during sex if you find sex is causing irritation
• Try a different brand of lubricant or spermicide if you find it irritating

When to see a doctor

If you have vaginitis symptoms and are unsure of the cause, it's always best to see a healthcare provider. They can find the root cause and prescribe the correct treatment.

If you have recurrent yeast infections and know how to treat them at home, you can use over-the-counter medication. But if it doesn't clear up and symptoms aren't improving with self-care, then schedule a visit to your doctor.

What upsets the normal vaginal ecosystem?

The vaginal ecosystem is quite delicate and can be upset by:

• Hormonal changes
• A low immune system
• Diabetes mellitus
• Antibiotics
• A reaction to another person's genital chemistry
• Use of scented products on your vulva or vagina
• Douching
• An allergic reaction

What's the outlook if you develop an infection?

All vaginal infections are easily treated and have no long-term effects. However, symptoms can be similar to those of STIs. If you have an STI and it is left untreated, you may be at risk of severe, long-term complications. Always seek advice from your doctor if you are unsure of the cause of your vaginitis.

What are the signs of infection in a woman?

Women with vaginitis usually experience the following symptoms in the vagina or vulva:

• Pain 
• Swelling 
• Discoloration
• Pain or discomfort during sex or masturbation
• A change in your vaginal discharge that is different from normal
• Stinging when passing urine
• Increased need to urinate

How do you know if you have an infection down there?

Get to know your genitals. Look at your vulva with a mirror so you know what it usually looks like. Get to know your vaginal discharge, what it looks like, how it smells and how it changes with your menstrual cycle. If you know your genitals and vaginal discharge, you can look out for any changes and spot them quickly. If you notice symptoms like those listed above, head to your healthcare provider for advice.