Vaginitis

Vaginitis is inflammation of the vagina that causes discharge, odor, itching, irritation, or burning. It is a symptom with several possible causes, including infections, hormonal changes, and irritation, rather than a single disease. The most common infectious causes are bacterial vaginosis, candidiasis (yeast infection), and trichomoniasis. Noninfectious causes include irritant vaginitis from soaps, detergents, spermicides, or tight clothing, and atrophic vaginitis associated with aging or menopause.

Diagnosis typically involves a medical history and a pelvic examination, with laboratory tests of vaginal discharge when appropriate. Tests may measure vaginal pH, microscopic examination of cells and bacteria, and specific tests for candida, bacterial vaginosis, or trichomonas. The goal is to identify the cause and rule out other conditions with similar symptoms.

Treatment depends on the cause. Bacterial vaginosis is usually treated with antibiotics such as metronidazole or clindamycin. Yeast infections are treated with antifungal medications, either oral (fluconazole) or topical. Trichomoniasis is treated with metronidazole or tinidazole for the patient and, if possible, her partner. Noninfectious vaginitis is managed by eliminating irritants and, in cases of atrophic vaginitis, addressing estrogen deficiency under medical supervision.

Most episodes improve with appropriate treatment. Recurrence is common, especially with bacterial vaginosis and yeast infections. Preventive measures include avoiding irritants, limiting douching, using condoms, and seeking care for recurrent symptoms.

Vaginitis affects people of reproductive age most often, but atrophic vaginitis can occur after menopause. In pregnancy, treatment choices are guided by safety for the fetus and the specific diagnosis.