What is vaginitis?

The vagina has its own microbiome of bacteria and yeast. Vaginitis is an inflammation or irritation of the vagina or vulva that can develop any time the normal balance of yeast or bacteria changes. Vaginitis is a very common infectious disease of the female genital tract during the childbearing years. Vaginitis is the most common reason why a woman sees her OB/GYN.

It is a condition that affects almost all women at some time during their lives. It can lead to adverse obstetrical and gynecological outcomes including pelvic inflammatory disease, postoperative infections, intrauterine infections, and neonatal infections. There are many causes and types. Treatment is based on the cause.

What are the symptoms of vaginitis?

• The vagina and vulva appear discolored, irritated, swollen, and uncomfortable
• Odorous discharge
• Excessive discharge
• Itching, burning and pain. The three most common types of vaginal infection or vaginitis are yeast infection, bacterial vaginosis, and trichomoniasis.

How is vaginitis diagnosed?

During your pelvic exam with Dr. Patel she will look for swelling, redness, irritation, and discharge, and she will take a swab of the vaginal tissues to collect vaginal secretions. She may also order a urinalysis and look at the sample under a microscope to see if there is an overgrowth of fungus or bacteria and the type of bacteria. Based on the findings she will render a diagnosis and offer the appropriate treatment, which can include creams, vaginal suppositories, oral tablets, and pills. 

What are the common causes of vaginitis?

• A yeast infection is typically caused by an overgrowth of the Candida albicans fungus. The fungus is normal in small amounts but when the balance is altered, the yeast can overgrow and cause symptoms. Symptoms are itching, burning, and irritation of the vulva, and a thick white discharge. Pregnancy, antibiotics, diabetes, and immune system dysfunction can increase the risk of a yeast infection. Treatment involves vaginal or oral antifungal medications. OTC medications can work but if your symptoms may be caused by another problem this treatment will not be effective.
• Bacterial vaginosis is caused by an overgrowth of bacteria in the vagina but there is no inflammation. It is caused by an overgrowth of normal bacteria that live in the vagina. Symptoms include a strong fishy odor and discharge, especially during your period and after sex. The discharge is thin and dark gray but can appear greenish. This type of vaginitis is often treated with antibiotics orally or vaginally. It frequently returns so treatment may be needed for 3-6 months. Sexual partners do not need to be treated.
• Aerobic vaginitis was first identified in 2002 and is caused by aerobic bacteria whereas as bacterial vaginosis is caused by anerobic bacteria. Both are important causes of premature birth in pregnant women. Symptoms include vaginal inflammation, a sticky yellow or green discharge with a rotten odor, and erosion of the vaginal tissues. It can affect any woman regardless of age whether pre or post menopause. It is associated with STIs. Treatment involves antibiotics.
• Trichomoniasis is caused by a parasite called Trichomonas vaginalis. It is a sexually transmitted infection. Symptoms include a yellow or green vaginal discharge, and a fishy odor, burning, irritation, redness, swelling and possibly pain with urination. Contracting trichomoniasis increases the risk of contracting other STIs. This type of vaginitis is also often treated with antibiotics. Sexual partners do need treatment.
• Atrophic vaginitis is a condition linked to a lack of estrogen often due to menopause or breastfeeding. It is not an infection but can cause discharge and irritation. Symptoms include dryness, burning, itching, vaginal discharge, and pain during sex. This type of vaginitis is treated with estrogen, as a vaginal cream or oral medication.

If you think you might have vaginitis, it is important to see Dr. Patel so that you can receive the correct treatment. Left untreated, vaginitis can increase your risk for other infections, such as sexually transmitted infections (STIs).

Dr. Dwaita Patel is a board-certified obstetrician and gynecologist at City OB+GYN in New York City, and a fellow of the American College of Obstetrics and Gynecology (FACOG). She specializes in women’s health, and the full scope gynecological services, including routine exams, contraceptive counseling, breast and ovarian cancer screenings, osteoporosis screening, premenstrual syndrome management and more.

Dr. Patel is smart and kind and finds great joy and fulfillment in her work. She offers the full scope of obstetrics including pre-pregnancy, prenatal, labor and delivery and postpartum care for low and high-risk patients. She also offers medical treatments and minimally invasive surgery for gynecologic conditions. All deliveries and major surgeries are performed at Tisch Hospital/NYU Langone Medical Center in Manhattan.