Vaginitis

Vaginitis is an inflammation of the mucous membrane that lines the vagina. This common problem can also be associated with vulvitis (inflammation of the vulva).

Vaginitis symptoms include itching, burning, redness, pain during urination and sexual intercourse, and abnormal vaginal discharge.

This common health problem has many causes and can be divided into two types:

Non-infectious:

• Vaginitis can be caused by irritants, an allergic reaction, friction, or an injury.
• Menopausal women are more likely to have atrophic vaginitis (or vaginal atrophy), which causes the vaginal walls to become drier and more easily inflamed.

Infectious:

Yeast infection (candidiasis)

Vaginal yeast infections are caused by an imbalance in the vaginal flora and a change in the vagina's pH level. When this happens, microorganisms usually present in the vagina (Candida albicans in 90% of cases) can multiply and cause an infection. Several factors can throw off the vagina’s acid/alkaline balance, the most common of which are:

• hormonal changes related to pregnancy, menstruation or contraceptives
• age (women in their thirties and forties are especially prone)
• sexual activity
• poorly controlled diabetes
• antibiotics
• chemotherapy
• strong emotions
• sportswear that causes chafing or traps moisture (cycling shorts, swimsuits)

Symptoms of yeast infection include severe itching and a thick white discharge that has the consistency of cottage cheese.

Bacterial vaginosis

As the name indicates, bacterial vaginosis (or BV) is an infection of the vagina caused by bacteria. An imbalance in the vaginal flora can cause certain bacteria to multiply more than usual and cause an infection. BV is characterized by a fishy odour, a whitish-grey discharge, and possible irritation and itching. It is not a sexually transmitted infection (STI).

Trichomoniasis (or trichomonas vaginitis)

Trichomoniasis is transmitted through sexual activity but, contrary to other STIs, it is easily treatable and is not a health concern. It is caused by a tiny parasite found on the foreskin of the penis or in vaginal discharge. Symptoms usually appear anywhere between 5 and 28 days after unprotected sexual intercourse.

Foul-smelling, yellow-green or white discharge is common with this type of vaginitis, as are itching and pain during urination and intercourse.

If you have symptoms of vaginitis, you should see a doctor in the following cases:

• You are a girl who is under 12 or prepubescent.
• You are pregnant.
• You are diabetic.
• You have bleeding.
• This is your first infection.
• This is your second infection in less than 2 months or you have more than 4 infections a year.
• You have a fever, abdominal pain, and an increased urge to urinate.
• You have abundant, strong-smelling vaginal discharge. Yeast infection discharge is thick and white with the consistency of cottage cheese. Bacterial vaginosis produces a whitish-grey discharge that has a fishy smell. Trichomonas vaginitis produces a frothy, yellow-green discharge. These last two types of vaginitis can only be treated with prescription drugs.

Avoid anything that may irritate the vagina or that can promote the growth of fungi and the spread of bacteria:

• scented hygiene products
• tight clothing
• vaginal douches
• oils, strong soaps, perfumes
• underwear made from synthetic fabrics

Although most types of vaginitis are not STIs, you should always have protected sex.

Yeast infection treatment

When vaginitis is caused by fungi, you don’t need to see a doctor right away, as you can first treat your infection with over-the-counter (OTC) antifungal medications. These include vaginal tablets and suppositories (or ovules), creams, and single-dose oral tablets. Use cream and suppositories at bedtime for 1 to 7 consecutive days and continue use during your period. Be sure to wear panty liners throughout the course of treatment. If OTC medications don’t work, you should see a doctor.

Sexual partners generally don’t need treatment, as yeast infections are rarely transmitted. If your partner notices red skin and itching around the head of the penis, he can apply an antifungal cream 2 times a day for 7 days.

Bacterial vaginosis and trichomonas vaginitis treatment  

If you think you have bacterial vaginosis or trichomonas vaginitis, you will need to get a medical examination, as these conditions are treated with topical or oral antibiotics that require a doctor's prescription.

Your sexual partner may need to be treated as well, depending on the type of bacteria in question.

Non-infectious vaginitis treatment

When vaginitis is caused by an irritant, simply remove the cause of the irritation. Cold compresses and moisturizing ointments (such as petroleum jelly or Ihle’s paste) can provide relief and help the symptoms go away. For severe itching, cortisone-based creams can be used for up to 48 hours.

In menopausal women, decreased estrogen production can lead to vaginal atrophy, in which the vagina becomes drier and more easily irritated. Although vaginal dryness is unfortunately chronic, you can relieve symptoms by using a lubricant either regularly or during sexual intercourse.

Probiotic capsules (inserted vaginally) can also help maintain the vaginal flora. However, a number of studies have failed to show the effectiveness of oral probiotics.

If you aren’t sure what type of vaginitis you have, you should see a doctor. If you suspect you have vaginitis, don’t be afraid to talk to your pharmacist, who can answer your questions and offer advice and guidance on the right treatment for you