KidsMD Health Topics

Vaginitis

  • Overview

    Vaginitis refers to any inflammation or infection of the vagina.

    • It is a common gynecological problem found in females of all ages.
    • Most females will have at least one form at some point in their lives.

    What causes vaginitis?

    Many things can cause vaginitis, including:

    • bacteria
    • yeast
    • viruses
    • chemicals in creams or sprays
    • clothing can cause vaginitis
    • organisms that are passed between sexual partners

    In addition, the vaginal environment is influenced by a number of different factors including:

    • your child's health
    • her personal hygiene
    • medications and hormones (particularly estrogen)
    • the health of her sexual partner
    • her clothing (including tight jeans and synthetic fiber underwear)

    A disturbance in any of these factors can trigger vaginitis.


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    Boston Children's Hospital 
    333 Longwood Avenue
    Across from the Main Hospital
    Boston MA 02115

     617-355-7648
  • In-Depth

    What are the most common types of vaginitis?

    The following are the most common types of vaginitis:

    Diagnoses of vaginitis can be tricky, because each type has a different cause and may present different symptoms, and more than one type of vaginitis may be present at one time (with or without symptoms). We'll talk about each of these types below.

    Candida (yeast infection)

    • Yeast infections, as they are commonly called, are caused by one of the many species of fungus known as candida, which normally live in the vagina in small numbers.
    • Yeast infections can also be present in the mouth and digestive tract in both males and females.
    • A yeast infection in the mouth is also known as "thrush".

    What causes a vaginal yeast infection?

    Since yeast is normally present and well-balanced in the vagina, infection occurs when something in the body upsets this normal balance, for example, an antibiotic to treat another infection. In this case, the antibiotic kills the bacteria that normally protects and balances the yeast in the vagina. In turn, the yeast overgrows, causing an infection.

    Other factors that can cause this imbalance to occur include:

    • pregnancy, which changes hormone levels
    • diabetes, which allows too much sugar in the urine and vagina

    What are the symptoms of a vaginal yeast infection?

    While each female may experience symptoms of a yeast infection differently, some of the most common include:

    • a thick, white cottage cheese-like vaginal discharge that is watery and usually odorless
    • itchiness and redness of the vulva and vagina

    Who is at risk for vaginal yeast infections?

    While any female can develop a yeast infection, there may be an increased risk for females who:

    • have had a recent course of antibiotics
    • are pregnant
    • have diabetes that is not well-controlled
    • are using an immunosuppressant medication
    • are using high-estrogen contraceptives
    • have a thyroid or endocrine disorder
    • are undergoing corticosteroid therapy, which slows the immune system

    Bacterial vaginosis

    • Bacterial vaginosis (BV) is the most common type of vaginitis in females of reproductive age.
    • Unlike a yeast infection, BV is caused by bacteria.
    • With a bacterial vaginosis infection, certain species of normal vaginal bacteria grow out of control and trigger inflammation.
    • The cause of bacterial vaginosis is unknown.

    What are the symptoms of bacterial vaginosis?

    While each adolescent may experience symptoms differently, some of the most common include:

    • a milky, thin discharge at times, or a heavy, gray discharge
    • "fishy" odor of discharge

    The symptoms of bacterial vaginosis may resemble other conditions. Always consult your physician for a diagnosis.

    Trichomoniasis

    • Trichomoniasis, trichomonas, or "trich," is a sexually transmitted infection.
    • It is caused when a one-celled parasite called Trichomonas vaginalis passes between partners during sexual intercourse.
    • Since most males with trichomoniasis will not have any symptoms, the infection often goes undiscovered until the female develops symptoms.

    What are the symptoms of trichomoniasis?

    While each adolescent may experience symptoms of trichomoniasis differently, some of the most common include:

    • a frothy, often musty-smelling greenish-yellow discharge
    • itching in and around the vagina and vulva
    • burning during urination
    • discomfort in the lower abdomen
    • pain during intercourse

    Chlamydia

    • Chlamydia is the most common sexually transmitted disease in the United States, although it often goes undiagnosed.
    • It is most commonly diagnosed in young women between the ages of 18 and 35 who have multiple sexual partners.
    • If left untreated, chlamydia often leads to pelvic inflammatory disease (PID), which increases a female's risk of infertility, pelvic adhesions, chronic pelvic pain and ectopic pregnancy (pregnancy implants outside the womb).
    • Chlamydia, caused by the bacterium Chlamydia trachomatis, exists in a number of different strains.

    What are the symptoms of chlamydia?

    Unfortunately, many females have no symptoms, thus prolonging diagnosis and treatment and possibly spreading the disease. While each female may experience symptoms differently, the most common include:

    • increased vaginal discharge
    • light bleeding, especially after intercourse
    • pain in the lower abdomen or pelvis
    • burning during urination
    • pus in the urine
    • redness and swelling of the urethra and labia

    How is chlamydia treated?

    Generally, treatment for chlamydia involves taking antibiotics.

    Viral vaginitis

    Viruses are a common cause of vaginitis, most commonly spread through sexual contact. Two of the most common viruses are the herpes simplex virus (HSV, or simply "herpes") and the human papillomavirus (HPV).

    With HSV (herpes):

    • The primary symptom is pain in the genital area associated with lesions and sores. These sores are generally visible on the vulva or vagina, but occasionally are inside the vagina and can only be found during a pelvic examination.
    • Often stress or emotional situations can be a factor in triggering an outbreak of herpes.

    With Human papillomavirus (HPV):

    • Painful warts may grow on the vagina, rectum, vulva or groin. However, visible warts are not always present, in which case the virus is generally detected by a Pap test.
    • There is now a vaccine that prevents the types of HPV most cases of cervical cancer and genital warts.
      • The vaccine, Gardasil®, is given in three shots over six-months. 
      • The vaccine is routinely recommended for 11 and 12 year old girls. It is also recommended for girls and women age 13 through 26 who have not yet been vaccinated or completed the vaccine series.

    Noninfectious vaginitis

    • Noninfectious vaginitis usually refers to vaginal irritation without an infection being present.
    • Most often, this is caused by an allergic reaction to, or irritation from, vaginal sprays, douches or spermicidal products.
    • Noninfectious vaginitis may be also be caused by sensitivity to perfumed soaps, detergents or fabric softeners.

    What are the symptoms of noninfectious vaginitis?

    While each girl may experience symptoms differently, some of the most common include:

    • vaginal itching
    • vaginal burning
    • vaginal discharge
    • pelvic pain (particularly during intercourse)
  • Tests

    How is a vaginal yeast infection diagnosed?

    Diagnostic procedures for yeast infections often include:

    • a complete medical history
    • a microscopic examination of the vaginal discharge
    • physical and pelvic examination

    How is bacterial vaginosis treated?

    Bacterial vaginosis is generally treated with oral antibiotics.

    Diagnosing trichomoniasis:

    Some women may not show any symptoms but still have the condition. The symptoms of trichomoniasis may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

  • What treatments are available for vaginal yeast infections?

    Treatment for yeast infection may include:

    • anti-fungal, vaginal creams and suppositories
    • vaginal tablets
    • antibiotics

    Treatment for trichomoniasis:

    Both partners must be treated for trichomoniasis so that they don't re-infect each other. Treatment generally involves taking oral antibiotics. If a female has more than one sexual partner, each partner (and any of their other partners) should also be treated.

    Treatment for noninfectious vaginitis:

    Treatment for noninfectious vaginitis generally includes estrogen creams or oral tablets, which can restore lubrication and decrease soreness and irritation.

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