Vaginitis: Symptoms, Causes, and Treatment

By Dr. Ben Kim

Vaginitis is a condition that often goes unaddressed by women and their health care providers due to many people often feeling embarrassed about it. Vaginitis is also frequently misdiagnosed as a urinary tract infection, which can leave a woman unaware of lifestyle factors that are chronic, recurrent causes of vaginitis.

What exactly is vaginitis? By definition, it is an inflammatory condition of the mucosal lining of the vagina. A urinary tract infection, on the other hand, is an infection found in any part of the genitourinary (GU) system; the kidneys, the ureters, the bladder, and the urethra are the four major regions of the GU system where a urinary tract infection can take place.

For diagnostic and treatment purposes, vaginitis is typically classified into one of the following three categories:

  1. Infectious Vaginitis - represents approximately 90 percent of all cases of vaginitis in women who are of reproductive age. Infectious vaginitis is typically caused by bacterial overgrowth, yeast overgrowth, an infection by a protozoan called Trichimonas vaginalis, or various sexually transmitted organisms.
  2. Irritant Vaginitis - caused by allergic-type reactions to condoms, spermicides, topical medications, tampons, soaps, perfumes, douches, or semen.
  3. Hormonal Vaginitis - most often occurs in postpartum or postmenopausal women in the form of atrophic (thinning) vaginitis. Hormonal vaginitis can also occur in prepubescent girls due to endocrine system imbalance.

Symptoms Of Vaginitis

All three categories of vaginitis can produce the following symptoms:

  • Itching and/or irritation of the genital region
  • Redness in the perineal area (area between vagina and anal sphincter)
  • Redness of the labia majora and labia minora - sometimes, redness in these areas can be hidden by pubic hair
  • Burning sensation or other type of discomfort when urinating
  • Vaginal discharge
  • Objectionable vaginal odor

When a woman is in good overall health and is able to address the root cause(s) of vaginitis, the symptoms can gradually diminish on their own. On the other hand, if a case of vaginitis is caused by an infectious organism and the woman doesn't take measures to recover, such an infection can lead to permanent health challenges. For example, a young girl who experiences vaginitis that progresses to a urinary tract infection can potentially experience permanent renal damage if the infectious process is able to travel up to the kidneys. Another example would be chlamydia-induced vaginitis progressing to an infection of the fallopian tubes and/or the ovaries, a situation that could result in infertility.

Causes Of And Treatment For Vaginitis

Infectious Vaginitis

Some cases of chronic, recurrent vaginitis can be attributed to a lack of proper hygienic care of the genital, perineal, and anal sphincter regions. Girls and women of all ages should always wipe from front to back after having a bowel movement. Infant girls should also be wiped from front to back when being cleaned after a bowel movement. Wiping from back to front can transfer undesirable organisms from the anal region to the vagina and is in my clinical experience, a common cause of chronic, recurrent vaginitis.

For the same reason as cited in the paragraph above, it is important to ensure that a woman's sexual partner does not make contact with her anal region and then make subsequent contact with her vaginal region. Because this topic can be embarrassing to discuss, it is often another overlooked cause of chronic, recurrent infectious vaginitis.

Infectious vaginitis that is caused by yeast overgrowth is best addressed by limiting or completely avoiding sugar and refined carbohydrates. Regular intake of beneficial bacteria and raw garlic can also be helpful for Candida-induced vaginitis. Unless faced with a life or limb-threatening situation, antibiotics should be avoided, as prolonged intake of antibiotics can disrupt a woman's flora enough for yeast overgrowth and Candida-induced vaginitis to occur.

The potential for sexually transmitted organisms to cause vaginitis is one of many good health-related reasons to experience sex only in a mutually monogamous relationship.

Irritant Vaginitis

Because any number of synthetic chemicals and materials can induce an allergic-type reaction along the mucosal lining of the vagina, the best approach to treating all cases of irritant vaginitis is to avoid having synthetic chemicals and materials contact the vagina whenever possible.

Scented soaps should never be used to clean the vagina area. A plain, unscented soap like ivory can be used to clean around the genital region, but should not make contact with the actual mucosal lining of the vaginal canal; all mucosal linings are best cleaned with water only, as soap will dry out mucosal linings that are meant to stay moist.

Bubble bath and other scented products should not be added to bath water.

Feminine hygiene sprays should be avoided, as should contraceptive foams and suppositories.

Regular tampon use should be avoided if possible, as tampons can dry out and irritate the mucosal lining of the vagina, just as soap can.

Hormonal Vaginitis

For postpartal and postmenopausal cases of hormonal vaginitis, the best first approach is to ensure that the woman is not experiencing estrogen dominance. After addressing lifestyle factors in a way that ensures a healthy balance between estrogen and progesterone levels, if possible, it is best to engage in sexual intercourse (in a mutually monogamous relationship) with a natural, non-toxic lubricant on a regular basis. Regular coitus can help to stimulate blood flow and nutrients to the mucosal lining of the vaginal wall, which in turn, can help to add thickness, strength, and elasticity to this region.

For prepubescent girls who experience hormonal vaginitis, avoiding synthetic hormones found in factory farmed animal products is perhaps the single most important step to take to ensure that the foods they are eating are not contributing to endocrine dysfunction. Significant emotional stressors should also be explored and addressed in a safe environment, possibly with a professional therapist. Finally, prepubescent girls should make every effort to avoid the use of synthetic chemicals and materials in and around their vaginal regions. In cases where menses has commenced, it be may worth the effort of using cloth pads rather than synthetic ones that may be laced with materials and chemicals that increase absorbancy.

For all three categories of vaginitis, in some cases, the use of conventional medical creams can reduce discomfort and accelerate recovery time. Even so, it is in the best interest of every person who experiences vaginitis to be aware of all of the major causes of vaginitis described in this article.

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