Vaginitis – Causes, Types and When to Seek help

What is vaginitis

Also called vaginal inflammation. However, this is a general name for a number of symptoms that may indicate other diseases. Moreover, vaginitis can be caused by improper hygiene of the intimate area, allergies, tight clothes and even hormonal changes. So, it is crucial to see your doctor, since even he/she needs additional tests to identify the real cause.

Causes and types of vaginitis

The common cause is an imbalance of organisms – bacteria and yeast – in the vagina. Yet, this imbalance can be caused by many factors, including:

Bacterial vaginitis. An increase in the number of bacteria in the vagina. It is usually a symptom of diseases caused by a variety of bacteria. Here, the main risk is the development of aerobic vaginitis (AV). It’s defined with abnormal vaginal microflora containing aerobic and intestinal bacteria, vaginal inflammation and insufficient maturation of the epithelium. 
Candida infection. The candida fungus, which is normally found in small amounts in the vagina, over proliferates. This disease is better known as “thrush”. Like the previous condition, it is mostly a symptom of other problems listed below.
Sexually transmitted infections (STIs): chlamydia, gonorrhea, trichomoniasis.
Viral vaginitis. Inflammation caused by a virus, namely herpes simplex virus (HSV) or human papillomavirus (HPV), which are sexually transmitted.
Allergic reaction. Detergents, perfumed hygiene products, douching, spermicides and vaginal sprays – an individual reaction to all of these can cause vaginitis.
Atrophic vaginitis. Due to the removal of the ovaries or menopause, the level of estrogen in a woman’s body decreases. This leads to thinning and dryness of the vaginal mucosa. Hence, you might have painful sex and discomfort in the intimate area.
Trauma. Tight clothing, improper insertion of a tampon or intense intercourse can cause vaginitis.

Nonetheless, temporary atrophic vaginitis can also occur during breastfeeding due to hormonal fluctuations.

Risk Factors

Certain factors can increase your risk of getting vaginitis:

Having multiple sexual partners or having a new sexual partner. Doctors don’t fully understand the link between sexual activity and vaginitis, but the condition is more common in women who have multiple sex partners or a new sex partner. Bacterial vaginitis among women with STDs is also more common in women who have sex with women.
Update from February 2025: Australian researchers have proven that bacterial vaginal inflammation (bacterial vaginosis) can be transmitted sexually.
Douching. The practice of washing your vagina with water or, even more so, detergent disrupts the natural balance of your vagina. This can lead to excessive growth of anaerobic bacteria and cause bacterial vaginitis. Proper intimate hygiene does not require deep washing and requires special products selected according to your age.
Lack of Lactobacillus. If there are not enough beneficial Lactobacillus in your natural vaginal environment, you are more likely to develop bacterial vaginitis. Proper intimate hygiene does not require deep washing and calls for special products chosen according to your age.

Symptoms of vaginitis

Vaginal discharge that varies depending on the phase of the cycle or other natural factors is normal. You should pay attention if they become different from what you are used to.

Foremost, you can figure out in which direction the imbalance of yeast and bacteria has fluctuated from the following signs:

If yeast (fungi) predominates, the main symptom is a curd-like vaginal discharge. If bacteria dominate, the discharge will have a noticeable “fishy” smell. Both conditions cause discomfort in the intimate area, including itching and burning.

But you know what, you can have both problems at the same time. For example, a sexually transmitted disease and a yeast infection.

So, let’s see what some symptoms may indicate:

Complications

Complications are caused not by vaginitis itself, but by the original disorders. This includes sexually transmitted infections; secondary infections that become possible due to a decrease in local and general immunity, and the effects of damage to the vagina due to allergies and trauma.

Premature birth. In pregnant women, bacterial vaginitis is associated with premature birth and low birth weight babies.
Cracks or even wounds in the intimate area.
Risk of infection after gynecological surgery. 
Pelvic inflammatory disease (PID). This condition may require emergency care and lead to infertility.
Bacterial vaginitis makes women more vulnerable to sexually transmitted infections such as HIV, herpes simplex virus, chlamydia, or gonorrhea. If you have HIV, bacterial vaginitis increases the chances to pass the virus to your partner.
Oral thrush due to secondary infection.
Gastrointestinal problems due to an imbalance of yeast and bacteria.
Emotional depression. Needless to say, constant discomfort and inability to have normal sexual relations affect a woman’s mood negatively.

During a year-long study of patients at the Riga East University Hospital, which lasted a year, it was found that aerobic vaginitis is the second leading factor in the development of pre-cancerous conditions of the cervix, including cervical intraepithelial neoplasia. By the way, the leading one is smoking.

Treatment

Since vaginitis is mostly a symptom, it is essential to establish the cause. This should be done by your doctor based on the results of appropriate tests. Even if you have already treated vaginitis, do not self-diagnose! It can not only be ineffective, but also worsen your condition and complicate future treatment.

A study by Italian scientists during 2015-2019 found that due to the spread of multidrug-resistant bacterial strains in the case of aerobic vaginitis, some organisms that caused it are sensitive to antimicrobial drugs to which others are resistant. So, only the doctor must choose a therapy that will be effective against all types of bacteria that caused vaginitis in this particular case. It is simply impossible to do this without accurate laboratory data!

In order for the doctor to give you the right diagnosis, it is important to describe absolutely all the symptoms you have, as well as to prepare properly for the tests. Do not douche, do not use topical products, and wait with sex for 24–48 hours.

Depending on the diagnosis, your care provider will prescribe treatment, which may include antibiotics, probiotics – for infectious vaginitis. In case of a hormonal cause of vaginitis, you may be prescribed hormones (for example, estrogen). You will also be offered to exclude certain hygiene products or use clothes made of certain fabrics in case of allergic nature of the disease.

PRP-therapy

In the case of atrophic vaginitis, PRP therapy, or platelet-rich plasma treatment, has been successfully used for several years. An additional bonus of this method is the overall rejuvenation of the intimate area. It is also effective even in patients that haven’t had any effect from local hormone therapy. Moreover, recent studies have demonstrated the effectiveness of plasma therapy against lichen sclerosus, an inflammation that mainly affects the skin of the external genitalia of women and men over 50 years of age.

In Lior Medical Center, we use the Swiss Regen Lab system. It is the centrifuge and test tubes of this system that allow us to get a whole and intact platelet. The unique technology, confirmed by clinical studies, allows not only to solve gynecological problems, but to rejuvenate the skin, treat inflammation, alopecia, neurological disorders and orthopedic injuries.

Stay healthy!

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