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What is it?
Vaginitis is a generally generic name for
swelling, itching, burning or infection in the vagina that can be caused my
several different germs. The most common kinds of vaginitis are bacterial
vaginosis (BV) and yeast, a fungus. Vaginitis is short for vulvovaginitis — any
irritation in the vagina. It often causes an abnormal discharge.
How prevalent is it?
Vaginitis is one of the most common reasons women
seek health care. It affects all women — lesbian, straight, and bisexual —
regardless of sexual orientation. You will most likely have it some time in your
life. You may have it more than once. It usually is not serious. But it can be
annoying and uncomfortable.
Bacterial Vaginosis (BV) is the most common
vaginal infection in women of childbearing age. In the United States, as many as
16 percent of pregnant women have it.
How do you get it?
The cause of bacterial vaginosis is not fully
understood. BV is associated with an imbalance in the bacteria that are normally
found in a woman's vagina. The vagina normally contains mostly "good" bacteria,
and fewer "harmful" bacteria. BV develops when there is an increase in harmful
bacteria.
Not much is known about how women get BV. There
are many unanswered questions about the role that harmful bacteria play in
causing BV. Any woman can get BV. However, some activities or behaviors can
upset the normal balance of bacteria in the vagina and put women at increased
risk including:
1. Having a new sex partner or multiple sex
partners,
2. Douching, and
3. Using an intrauterine device (IUD) for contraception.
It is not clear what role sexual activity plays
in the development of BV. Women do not get BV from toilet seats, bedding,
swimming pools, or from touching objects around them. Women that have never had
sexual intercourse are rarely affected.
Questions About Vaginal Fluids
What are normal vaginal fluids like?
Vaginal fluids keep the vagina lubricated and
healthy. They are either thick and whitish or slippery and clear. It depends on
where you are in your menstrual cycle. There is little odor and no itching or
burning. Regular bathing keeps the fluids from getting stale or uncomfortable.
It is normal for these fluids to discolor underwear. The fluids come from the
walls of your vagina. They also come from your cervix at certain times in your
cycle. They leave the body through the vagina.
How much fluid you produce depends on the
hormones that guide your menstrual cycle. Usually there is more fluid just
before you ovulate, when you are pregnant, and/or when you are sexually excited
You will have less fluid just before your period, while you breastfeed, and
during menopause.
Questions About the Types of Vaginitis
What are the infections that cause vaginitis?
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1. |
Bacterial vaginosis (back-TEER-ee-al VA-ji-NO-sis).
The remainder of this article is about BV. |
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2. |
Candidiasis (can-di-DYE-a-sis), or yeast
infection. [See separate article ] |
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3. |
Trichomoniasis (trick-oh-mo-NEYE-ah-sis)
[See separate article ] |
What is bacterial vaginosis (BV)?
BV is a condition caused by several bacteria,
including gardnerella (gard-ner-EL-la) vaginalis. BV used to be called
"nonspecific vaginitis." Usually there is a heavy vaginal discharge. It is
grayish and frothy and has an unpleasant, "fishy" odor. BV is sometimes
caused or made worse by unprotected sexual contact that can disrupt the balance
of normal bacteria that protect the vagina. Certain body fluids, especially
semen, may be more disruptive for some women.
Diagnosis is made by examination of the vagina
and vaginal discharge. Various creams and gels, as well as oral medication, can
be used to treat BV.
Signs & Symptoms
Women with BV may have an abnormal vaginal
discharge with an unpleasant odor. Some women report a strong fish-like odor,
especially after intercourse. Discharge, if present, is usually white or gray;
it can be thin. Women with BV may also have burning during urination or itching
around the outside of the vagina, or both. Some women with BV report no signs or
symptoms at all.
Diagnosis and Treatment
A health care provider must examine the vagina
for signs of BV and perform laboratory tests on a sample of vaginal fluid to
look for bacteria associated with BV.
Although BV will sometimes clear up without treatment, all women with symptoms
of BV should be treated to avoid such complications as PID. Male partners
generally do not need to be treated. However, BV may spread between female sex
partners.
Treatment is especially important for pregnant
women. All pregnant women who have ever had a premature delivery or low birth
weight baby should be considered for a BV examination, regardless of symptoms,
and should be treated if they have BV. All pregnant women who have symptoms of
BV should be checked and treated.
BV is treatable with antibiotics prescribed by a health care provider. Two
different antibiotics are recommended as treatment for BV: metronidazole or
clindamycin. Either can be used with non-pregnant or pregnant women, but the
recommended dosages differ. Women with BV who are HIV-positive should receive
the same treatment as those who are HIV-negative. BV can recur after treatment.
Should I use tampons or pads while I'm being
treated?
In general, do what is most comfortable for you.
Insert treatment suppositories before going to bed, and do not use tampons
afterward during the night. Otherwise, the tampon may soak up the medicine. It's
okay to use tampons during the day for your period — especially toward the end
of treatment. Some women use pads or panty liners to help keep the medicine from
leaking onto clothing. Others find them irritating. Ask your clinician for
advice.
Can I have vaginal intercourse while I'm being
treated?
It is better not to. Intercourse — or other kinds
of sex play — may be uncomfortable or painful. Having sex may also aggravate
your symptoms and interfere with the effectiveness of treatment. If you and your
partner are being treated for a sexually-transmitted infection, you may
re-infect one another.
What are the health/sexual implications of an
infection?
In most cases, BV causes no complications. But
there are some serious risks from BV including:
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Having BV can increase a woman's
susceptibility to HIV infection if she is exposed to the HIV virus. |
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Having BV increases the chances that an
HIV-infected woman can pass HIV to her sex partner. |
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Having BV has been associated with an
increase in the development of pelvic inflammatory disease (PID)
following surgical procedures such as a hysterectomy or an abortion. |
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Having BV while pregnant may put a woman
at increased risk for some complications of pregnancy. |
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BV can increase a woman's susceptibility
to other STDs, such as chlamydia and gonorrhea. |
How can you prevent it?
BV is not completely understood by scientists,
and the best ways to prevent it are unknown. However, it is known that BV is
associated with having a new sex partner or having multiple sex partners. It is
seldom found in women who have never had intercourse.
The best way to avoid BV, then, would seem to be
to remain sexually abstinent, or at least limit your number of sex partners.
You should also avoid douching.
Resources for Additional Reading
CDC
American Social Health Association
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