Vaginitis - OAWHealth

Vaginitis

By Dr. Loretta Lanphier, ND, CN, HHP, CH

What is Vaginitis?

Vaginitis is a condition that is characterized by inflammation or infection in the vagina and/or vulva, the external portions of the female genitalia. It is also known as vaginosis, vulvitis, or vulvovaginitis, and is usually caused by infections of bacterial, fungal, or parasitic origins. Vaginitis may also be the result of an allergic or irritational reaction, or occur due to a drop in estrogen levels in the body. In general, symptoms include an abnormal vaginal discharge, itching, and burning.

There are four major types of vaginitis, and they are classified according to their respective causes:

  • Bacterial vaginosis:  As the name indicates, bacterial vaginosis is triggered by bacterial agents within the vagina. This very common form of vaginitis is thought to account for about 40-50% of all cases, and may affect about one out of every six pregnant women. Certain factors increase a women’s risk of contracting bacterial vaginosis. Among them are:
    • Race:  African American women have the highest incidence, while Asian women have a very low risk for this type of infection. The reason for this racial disparity is not known.
    • Sexual activity:  The risk is lower for celibate women, and increases for those who have multiple partners. Bacterial vaginosis can be passed through intimate contact, but it is not officially branded a Sexually Transmitted Disease (STD).
  • Candida vulvovaginitis:  This type of vaginitis is commonly known as a yeast infection, and in the majority of cases it is the result of a fungus called Candida albicans. This infection is sometimes labeled vulvovaginal candidiasis, candidal vaginitis, or monilial infection. It is estimated that about 75% of all women will have a yeast infection at least once in their lifetime. Chronic infections that occur more than four times annually are called recurrent vaginal candidiasis. Overall, about 25% of all vaginitis cases are yeast infections. Risk factors include:
    • Age:  Yeast infections are rarely found in prepubescent girls.
    • Sexual activity:  The risk is lower for celibate women. It is possible to pass infections via sexual relations, but yeast infections are not considered to be an STD.
    • Pregnancy:  Increases risk for yeast infections.
    • Diabetes: If left untreated, increases risk.
    • Certain medications:  The use of birth control pills, antibiotics, and steroid drugs increases risk.
  • Trichomoniasis:  This is the only form of vaginitis that is classified as an STD. It is sometimes called “trich,” and is a parasitic infection that is passed primarily through intimate contact. It accounts for about 15-20% of all vaginitis cases, and can infect men as well as women. The single-celled parasite responsible for trich is called Trichomonas vaginalis, and it is frequently associated with other STDs. Trich is particularly dangerous for those who are sexually promiscuous, because it has the ability to help spread the AIDS virus.
  • Atrophic vaginitis:  This is caused by a drop in estrogen levels. It is usually associated with hormonal changes due to menopause. With the onset of menopause, the vaginal tissues often get thinner and drier, making them more susceptible to irritation. This type of vaginitis is not caused by an infection.
  • Noninfectious vaginitis:  Various factors are involved with causing this form of vaginitis that is the result of irritating agents. These agents include vaginal sprays and douches, perfumed soaps, bubble baths, spermicidal products, condoms, Intrauterine Devices (IUDs) or allergic reactions to clothing or feminine care products. Like atrophic vaginitis, this type, as the name tells us, is also not the result of an infection.

What Are the Symptoms of Vaginosis?

A vaginal discharge is normal for most women at certain times of their cycle. A tip that you may have a case of vaginitis is a discharge that does not appear normal for you or one that shows up at an unusual time. Signs to watch out for that could indicate a problem include:

  • A change in color, odor, or quantity of discharge.
    • Bacterial vaginosis may produce a malodorous “fishy” smelling discharge that is often grayish-white.
    • Yeast infections have a thick, white discharge that is sometimes compared to cottage cheese.
    • Trichomoniasis may result in a frothy, greenish-yellow discharge. Men who contract it may have no symptoms at all, or a urethral discharge and/or recurring urethral inflammation (urethritis).
  • Vaginal itching or burning
  • Light vaginal bleeding
  • Painful intercourse
  • Painful urination

What Are the Causes of Vaginitis?

Each type of vaginitis is caused by different factors:

Bacterial vaginitis

  • The vagina is normally home to several beneficial types of bacteria. When this balance is maintained, the “good” bacteria outweighs the “bad.” About 90% of bacteria in a healthy women’s vagina is of the genus Lactobacillus. When this proportion changes due to the proliferation of other types of bacteria, an infection can occur.
  • Changes in the pH balance within the vagina can make it more environmentally friendly to bacterial infections. One way this occurs is through repeated intercourse over a short period of time. The use of some douches or other personal care products can also negatively alter vaginal pH.
  • Chronic dampness in the vaginal area can also increase your risk for bacterial vaginitis. This can be caused by tight, synthetic underclothing that is not absorbent.
  • Antibiotics, which are often prescribed to combat a bacterial vaginitis infection, can actually do more harm than good. They do not discriminate between the “good” or “bad” bacteria, but destroy them all on an equal basis. This only further contributes to the imbalance within the vagina. In addition to this problem, many antibiotics will not even work very well any more, especially if you have used them too often. The bacteria develop immunity to the drugs and become resistant to them. So, many uninformed patients will end up taking a drug that may not work and may in fact make the condition worse.

Yeast infections

  • These fungal infections are similar to bacterial infections in the sense that they are based on a change in the environment of the vagina that allows for the overgrowth of infectious fungal agents, and they are also negatively affected by antibiotics.
  • Yeast infections can also be brought on by such factors as:
    • The use of steroids such as corticosteroid drugs.
    • Diabetes that is not under control by diet or medication.
    • Hormonal changes resulting from pregnancy or menopause.
    • The use of birth control pills.

Trichomoniasis

  • Trich is caused by a parasite that lives in the vagina of infected women and the urethra of infected men. The cause and risks for trich are clear. It is an STD that can be avoided by not being sexually promiscuous.

Noninfectious vaginitis

  • Irritants such as feminine hygiene products, bubble baths, harsh soaps, or synthetic clothing. Anything that causes an allergic reaction or irritation in the vaginal area will increase the risk for noninfectious vaginal infections. Irritated skin is more likely to be successfully attacked by infectious bacterial, fungal, and parasitic agents as well, so these factors affect the incidence of all types of vaginitis.
  • Atrophic vaginitis, caused by a drop in estrogen and other hormones, is also noninfectious. These hormonal changes simply make the vagina and vulva more prone to irritation and the possibility of contracting other types of vaginitis due to broken, inflamed skin.

What Treatments Are Available for Vaginitis?

The mainline treatments are, to no surprise, to throw drugs at the problem. We already have discussed the issues with antibiotics. But there are other medication risks that you should be aware of. Often a doctor will prescribe hormonal supplements to deal with the atrophic vaginitis that many menopausal women are afflicted with. Beware of these, as they are usually synthetic hormones, and can have many negative side effects. There are natural alternatives available, but you have to be proactive about it and not just take your physician’s word for it.

The best choices for treating vaginitis involve preventative lifestyle changes that will keep you healthy and avoid most of the problems associated with vaginitis. There are also some treatments that can help that do not involve drugs. Here are a few tips:

  • One of the best things you can do is maintain or restore the natural balance of flora in the vagina. There are many good probiotic products available that will help you accomplish this. An added bonus is that they also work on the flora in your digestive tract too, which is also an important health issue. Another option that can quickly help with yeast infections or bacterial vaginitis is to use an unflavored organic yogurt that has live acidophilus cultures. The yogurt may be eaten and introduced directly into the vagina. Consuming it can maintain floral balance, while using it internally is a great way to stop vaginitis in its tracks.
  • While douching is not recommended because it can alter the natural balance of flora in the vagina, an occasional douche with boric acid or vinegar can help to restore pH balance by lowering the acidity of the vagina. Vinegar is milder than boric acid, and is preferred by many women. Use one tablespoon of white vinegar for each quart of lukewarm water.
  • Watch your diet.  Many women have allergies to certain foods that can make them more susceptible to vaginitis, mostly yeast infections. If you have recurring yeast infections you may also want to eliminate certain foods that yeast loves as well. Starve ‘em out, as they say. Yeast thrives on such things as alcohol, sugar, cheese, fermented foods, foods containing mold, chocolate, and soy sauce.
  • Be careful of over-the–counter yeast infection remedies. One possible mistake here is treating what you think is a yeast infection, but in reality it is not. Using a yeast infection medicine on a different type of vaginal infection can only make matters worse. It will worsen the existing condition, and may actually give you the yeast infection that you thought you already had! One study surveyed close to 400 gynecologists, and found that about 44% of their patients who were diagnosed with bacterial vaginosis had first treated themselves with OTC yeast infection medication.
  • A cold-compress in the vaginal area can help relieve burning and itching.

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