The vaginitis is an inflammation of the vagina that is usually caused by an infection, but not always. It results in irritation, itching or pain in the vulva or vagina, as well as “abnormal” vaginal discharge. We also speak of vulvo-vaginitis.
This condition is relatively common: 75% of women will be affected at least once in their life. Vaginitis is the most common reason for medical consultation in women.
Types of vaginitis
Infectious vaginitis. The most common vaginitis is caused by microorganisms, such as bacteria, viruses, parasites or yeast (yeast is a microscopic fungus).
Infectious vaginitis can be caused by:
- A disturbance of the balance of the vaginal environment. The vagina is a medium where many protective micro-organisms live, which constitute the vaginal flora (or Flora of Döderlein). The good balance of this flora helps to prevent the multiplication of harmful bacteria or yeasts and prevents infections. The vaginal environment has a relatively acidic pH. A change in pH or flora, but also abnormal levels of glucose, glycogen, antibodies and other compounds in vaginal secretions can unbalance the vaginal flora.
Similarly, age, intercourse, pregnancy, birth control pills, hygiene measures, or dress habits can disrupt flora. This can lead to an abnormal proliferation of bacteria ormushrooms already present in the vagina. Yeast vaginitis caused by different types of yeasts in the Candida family (also known as mycosis or vaginal candidiasis) and bacterial vaginosis caused by the bacterium Gardnerella vaginalis are the most common.
- A sexually transmitted infection (STI). The introduction of the parasite Trichomonas vaginalis into the vagina during sexual intercourse with an infected partner. This type of vaginitis is called trichomoniasis and it is an STI.
Atrophic vaginitis (resulting in vaginal dryness). This type of vaginitis is caused by a drop in estrogen levels after surgical removal of the ovaries or at menopause. Thinning and less vaginal mucosa are observed, which becomes more sensitive and irritates more easily.
Vaginitis of irritation. Vaginal inflammation may be caused by irritating chemicals or allergic reactions caused by spermicides, douches, detergents, scented soaps, fabric softeners, latex condoms used without lubricant or with too little lubricant or prolonged use of a tampon.
|Note. This document will focus on infectious vaginitis, which accounts for approximately 90% of cases of vaginitis.|
Possible complications of Vaginitis
In general, vaginitis does not cause complications. However, they can be problematic for pregnant women. Indeed, vaginitis caused by bacteria or the parasite Trichomonas vaginalis can cause premature deliveries.
Bacterial vaginitis and trichomoniasis also increase the risk of acquiring human immunodeficiency virus (HIV) and other infections during unprotected sex with an infected partner.
In addition, some vaginitis may tend to reoffend. Thus, nearly half of women with vaginal candidiasis will have a second infection. In total, about 5% of women of childbearing age have more than 4 candidiasis infections per year. However, recurrent vaginitis can significantly alter the quality of life and have a significant impact on the sex life of women with the disease. They are also more difficult to treat.
Symptoms of vaginitis – vaginal infection
- Pain and itching in the vagina , and often in the vulva.
- A significant change in odor, abundance, texture and color of vaginal discharge may be indicative of infectious vaginitis. In case of yeast infection, the losses are often whitish, with an appearance of curd. When it comes to a bacterial infection, they are rather gray or yellowish and smelly.
- A feeling of irritation or burning during urination and during intercourse.
- Swelling and redness of the vulva.
- A slight vaginal bleeding, in rare cases.
|Many women with an infectious vaginitis agent have no symptoms.
For example, the parasite Trichomonas vaginalis may remain in the vagina for several years without causing any symptoms.
People at risk for Vaginitis
- Women with diabetes whose disease is not well controlled (so living hyperglycemia crises) are more prone to yeast vaginitis, yeasts are fond of glucose.
- Pregnant women. Yeast vaginitis is 10 to 20 times more common during pregnancy. The bacterial vaginosis is more common, affecting 15% to 20% of pregnant women. The main reason for this is increased estrogen , pH, vaginal glycogen, and blood sugar in pregnant women.
Yeast Vaginitis and Bacterial Vaginosis
- Fatigue caused by lack of sleep, dieting, stress, medication, illness or any other condition that weakens the immune system.
- Taking antibiotics because they destroy the natural bacterial flora of the vagina . Corticosteroids can also stimulate the growth of Candida.
- Taking the contraceptive pill, some women.
- The wearing of synthetic fabric underwear and tight clothing, which retain body heat and create a moist environment conducive to the proliferation of yeast Candida.
- The consumption of foods rich in sugar.
- Estrogen treatment.
- Regular use of douching for “hygienic” purposes (3 or more times a month) or the use of intimate antiseptic products.
- Wearing a copper IUD.
- A new sexual partner or many partners (this is a hypothesis regarding bacterial vaginosis).
- Unprotected sex with an infected partner or with multiple partners.
Prevention of vaginitis – vaginal infection
|Basic preventive measures|
|Some ways to prevent vaginitis
|Measures to prevent recurrence|
|Adopt good eating habits. The vaginal environment is a reflection of the general condition of the body. A balanced diet low in fat and processed foods is needed to prevent vaginal infections. To promote the balance of vaginal flora and stimulate immune function, it is also recommended to consume rich foods:
vitamin A and beta carotene such as organ meats, liver, sweet potatoes, carrots and spinach;
Especially for yeast vaginitis, it is recommended to avoid consuming too much sugar, including sweet fruit juice.
Consume probiotics . The consumption of probiotics, in the form of yogurts, could be beneficial. Moreover, since the regular consumption of kefir, tempeh and sauerkraut contributes to maintain the health of the intestinal flora, it could have the same effect on the vaginal flora.
Medical treatments for vaginitis – vaginal infection
|It is important to consult a doctor if you think you have vaginitis in order to obtain a reliable diagnosis. It may be necessary to take vaginal swabs to find out the cause of the infection and make sure it is not just a vaginal dryness. It is also imperative to consult your doctor in case of symptoms of vaginitis accompanied by fever or unusual symptoms (vomiting, abdominal pain …), in case of pregnancy, risk of sexually transmitted infection or multiple vaginal infections. During the last months.|
Conventional treatments treat 90% of vaginitis in less than 2 weeks – and sometimes within a few days – if the risk factors are low.
Yeast vaginitis . In case of symptoms, it is treated with vaginal eggs or antifungal creams to apply in the vagina at bedtime, even during menstruation. Women who have already been diagnosed with such vaginitis and are well aware of the symptoms can purchase these medications with or without a prescription by seeking the advice of the pharmacist. For example, miconazole (Monistat), clotrimazole (Canesten) and tioconazole (Gynecure), Clotrimazole (mycohydralin), Sertaconasole (Monazol) …
Oral treatments are also available on prescription, such as nystatin (Mycostatin) and fluconazole (Diflucan). Sometimes yeast infections are recurrent: it is important to look for the underlying cause and avoid risk factors. Note that yeast vaginitis is not a sexually transmitted infection. The sexual partner can however be treated, only if it has symptoms (in the man, an inflammation of the glans). When the infection is caused by a species of Candida rarer than Candida albicans(involved in 90% of cases), treatment with boric acid by intravaginal route is sometimes proposed.
Bacterial vaginosis . Tablets, gels or creams containing antibiotics are prescribed to treat bacterial vaginosis. The most commonly used drug is metronidazole, administered orally or vaginally. Clindamycin can also be used. Abstain from alcohol during metronidazole treatment and for the next 48 hours (alcohol may cause cramps, nausea and vomiting). If symptoms persist after treatment, it is necessary to consult a doctor again. No treatment is recommended for the male sexual partner. Treatment is imperative for pregnancy even in the absence of symptoms.
Trichomoniasis . Trichomoniasis should be treated with a single dose of the drug metronidazole, obtained with a prescription from the doctor. For this type of vaginitis, it is important that all sexual partners be treated simultaneously to avoid recurrences, regardless of symptoms. Abstain from alcohol during metronidazole treatment and for the next 48 hours (alcohol may cause cramps, nausea and vomiting). Metronidazole should not be given during the first trimester of pregnancy. The doctor will then offer clotrimazole in cream or egg (intravaginally). In addition, some experts recommend that breastfeeding women stop breastfeeding for 24 hours after taking metronidazole.
– It is important to follow the dosage determined by the doctor, until the end of treatment, even if the symptoms have disappeared.
– Tell your doctor if symptoms persist or reappear 2 weeks after treatment.
– Sexual intercourse should be avoided during treatment to prevent pain (ie subsequent sexual blockages), prevent reinfection and reduce aggression to the vaginal mucosa. If not, have sex partners wear a condom provided that the intercourse is not painful.
– Some oil-based creams weaken latex condoms. Ask your doctor.
– Tell your doctor if you are pregnant.