Vaginitis

black and white image of woman with no clothes on, arms crossed covering lower regionVaginitis is an inflammation of the vagina. It often is caused by infections, some of which are associated with serious diseases.

The most common vaginal infections are:

  • Bacterial vaginosis
  • Trichomoniasis
  • Vaginal yeast infection

Some vaginal infections are transmitted through sexual contact, but others,
such as yeast infections, probably are not.

BACTERIAL VAGINOSIS

Bacterial vaginosis (BV) is the most common cause of vaginitis symptoms among
women of childbearing age. It previously was called nonspecific vaginitis or
Gardnerella-associated vaginitis. Health experts are not sure what role
sexual activity plays in BV.

BV reflects a change in the growth of vaginal bacteria. This chemical
imbalance occurs when different types of bacteria outnumber the normal, “good”
ones. Instead of Lactobacillus (a type of normal bacteria that can live
naturally in the vagina) being the most numerous, increased numbers of bacteria
such as Gardnerella vaginalis, Bacteroides, Mobiluncus, and
Mycoplasma hominis are found in the vaginas of women with BV.
Researchers are studying the role that each of these germs may play in causing
BV, but they do not yet understand the role of sexual activity in developing BV.
A change in sexual partners, using an IUD (intrauterine device), and douching
may increase a woman’s risk of getting BV.

Symptoms

The main symptom of BV is an abnormal, foul-smelling vaginal discharge. Some
women describe it as a fish-like odor that is most noticeable after having sex.
Nearly half of the women with signs of BV, however, have no symptoms. A health
care provider may see these signs while giving a physical examination and may
confirm the diagnosis by doing lab tests of vaginal fluid.

Other symptoms may include

  • Thin vaginal discharge, usually white or gray in color
  • Pain during urination
  • Itching around the vagina

Diagnosis

A health care provider can examine a sample of vaginal fluid under a
microscope, either stained or in special lighting, to look for bacteria
associated with BV. Then, they can diagnose BV based on

  • Absence of lactobacilli
  • Presence of numerous “clue cells” (cells from the vaginal lining that are
    coated with BV germs)
  • Fishy odor
  • Change from normal vaginal fluid

Treatment

Health care providers use antibiotics such as metronidazole or clindamycin to
treat women with BV. Generally, male sex partners will not be treated.

Complications

In most cases, BV causes no complications. There have been documented risks
of BV, however, such as an association between BV and pelvic inflammatory
disease (PID). PID is a serious disease in women which can cause infertility and
tubal (ectopic) pregnancy.

BV also can cause other problems such as premature delivery and
low-birth-weight babies. Therefore, some health experts recommend that all
pregnant women, whether or not they have symptoms, who previously have delivered
a premature baby be checked for BV. A pregnant woman who has not delivered a
premature baby should be treated if she has symptoms and laboratory evidence of
BV.

BV also is associated with increased chances of getting gonorrhea or HIV
infection. (HIV, human immunodeficiency virus, causes AIDS.)

TRICHOMONIASIS

Trichomoniasis (trick-oh-moe-nye-uh-sis) is one of the most common sexually
transmitted infections (STIs). According to CDC, an estimated 7.4 million new
cases occur in men and women every year in the United States.

Trichomoniasis is caused by a parasite called Trichomonas vaginalis.
Trichomoniasis is primarily an infection of the urogenital tract. The vagina is
the most common place for infection in women, and the urethra is the most common
in men.

Symptoms

Trichomoniasis, like many other STIs, often occurs without any symptoms. Most
infected men do not have symptoms. When women have symptoms, they usually appear
within 5 to 28 days of exposure to the parasite.

Although some infected women have minor or no symptoms, many do have
symptoms. The symptoms in women include

  • Heavy, yellow-green or gray vaginal discharge
  • Discomfort during sex
  • Vaginal odor
  • Painful urination

They may also have irritation and itching of the genital area and, on rare
occasions, lower abdominal pain.

If present, the symptoms in men include a thin, whitish discharge from the
penis and painful or difficult urination and ejaculation.

Diagnosis

A health care provider can diagnose trichomoniasis by performing laboratory
tests on fluid samples from the vagina or penis. When women are infected with
trichomoniasis, a pelvic examination reveals red sores on the cervix or inside
the vagina.

Treatment

Because men can transmit the disease to their sex partners even when they
don’t have symptoms, health experts recommend that both partners be treated to
get rid of the parasite. Health care providers usually use metronidazole in a
single dose to treat people infected with trichomoniasis. A person can get
trichomoniasis again after being treated successfully, however.

Prevention

The surest way to avoid getting STIs is to abstain from sexual contact, or to
be in a long-term mutually monogamous relationship with a partner who has been
tested and is known to be uninfected. Using a latex male condom consistently and
correctly during sex may help prevent the spread of trichomoniasis.

Complications

Research has shown a link between trichomoniasis and two serious
complications. Scientific studies suggest that trichomoniasis is associated with
at least a 3- to 5-fold increased risk of HIV transmission and may cause a woman
to deliver a low-birth-weight or premature infant. Scientists need to do
additional research to fully explore these relationships.

VAGINAL YEAST INFECTION

Vaginal yeast infection, or vulvovaginal candidiasis, is a common cause of
vaginal irritation. This common fungal infection occurs when there is an
imbalance of the fungus called Candida albicans. Although this
infection is not considered an STI, 12 to 15 percent of men develop symptoms
after sexual contact with an infected partner.

Yeast are always present in the vagina in small numbers, and symptoms only
appear with overgrowth. Health experts estimate that approximately 75 percent of
all women will have at least one yeast infection with symptoms during their
lifetimes.

Several factors are associated with increased yeast infection in women,
including

  • Being pregnant
  • Having uncontrolled diabetes mellitus
  • Using oral contraceptives or antibiotics

Other factors that may increase the incidence of yeast infection include
using

  • Douches
  • Perfumed feminine hygiene sprays
  • Topical antibiotics and steroid medicines

Wearing tight, poorly ventilated clothing and underwear also can contribute
to vaginitis. Women should work with their health care providers to find out
possible underlying causes of their chronic yeast infections.

Health experts do not know whether yeast can be transmitted sexually. Because
almost all women have the fungus in their vaginas, it has been difficult for
researchers to study this aspect.

Symptoms

The most frequent symptoms of yeast infection in women a

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