Sunday, November 23, 2014

Definition

Vaginitis is a term used to describe disorders that cause infection or inflammation of the vagina. Vulvovaginitis refers to inflammation of both the vagina and vulva, the outer area of labial and skin surrounding the vagina.

These conditions can result from an infection caused by organisms such as bacteria, yeast, or viruses, as well as by irritations from chemicals in creams, sprays, or even clothing that are in contact with this area. In some cases, vaginitis results from organisms that are passed between sexual partners.

Description

The term "yeast infection" is what most women think of when they hear the word vaginitis. However, a yeast infection is only one kind of vaginal infection. Vaginitis can be caused by several different organisms, sometimes at the same time, as well as by hormonal changes, allergies, or irritations.

Vaginitis can also be caused by antibiotic use, diabetes, excessive alcohol, steroid use, a weakened immune system, abrasions of the vagina, or tight non-cotton underwear.

Causes

There are six most common types of vaginitis. These are:

1. Candida or yeast infections

2. Bacterial vaginitis

3. Trichomoniasis vaginitis

4. Chlamydia vaginitis

5. Viral vaginitis

6. Noninfectious vaginitis

Although each of these types of vaginal infection can have different symptoms, it is not always easy for an individual to figure out what type of vaginitis she has - in fact, diagnosis can even be tricky for an experienced clinician. Part of the problem is that sometimes more than one type of vaginitis can be present at the same time. Often vaginitis is present with no symptoms at all.

Yeast infections are a common cause of vaginitis. Yeast infections produce a thick, white vaginal discharge with the consistency of cottage cheese. Although the discharge can be somewhat watery, it is odorless. Yeast infections usually cause the vagina and vulva to be very itchy and red. An antibiotic taken for a urinary tract infection can kill "friendly" bacteria that normally keep the yeast in balance; as a result, the yeast overgrows and causes the infection.

Bacterial vaginitis results in a vaginal discharge. The discharge is usually thin and milky and is sometimes described as having a "fishy" odor. This odor may become more noticeable after intercourse. Since bacterial vaginitis is caused by bacteria, treatment is usually with antibiotics.

Trichomonas, commonly called "trick," is caused by a single-celled organism tht is a member of the protozoa family of microorganisms. When this organism infects the vagina it can cause a frothy, greenish-yellow discharge. Often this discharge will have a foul smell. Women with trichomonal vaginitis may complain of itching and soreness of the vagina and vulva, as well as burning during urination. These symptoms may be worse after a menstrual period. This type of vaginitis can be transmitted through sexual intercourse.

Chlamydia, a sexually transmitted disease, can cause vaginitis. Unfortunately, most women do not have symptoms. A vaginal discharge is sometimes present with this infection but not always. More often a woman might experience light bleeding especially after intercourse. chlamydial vaginitis is most common in young women under the age of 30 who have multiple sex partners.

Viral vaginitis can be caused by herpes simplex virus that is spread by sexual intercourse. The primary symptom of herpes vaginitis is pain associated with lesions or sores. These sores are usually visible on the vulva or the vagina and can only be seen during a gynecologic exam.

Noninfectious vaginitis is most often caused by an allergic reaction or irritation from vaginal sprays, douches, or spermicidal products. The skin around the vagina can also be sensitive to perfumed soaps, detergents, and fabric softeners. No infection is present.

Symptoms

The common symptoms of vaginitis are itching, burning, and vaginal discharge that is different from the normal secretions. The itching and burning can be inside the vagina or on the skin or vulva just outside the vagina. Discomfort during urination or sexual intercourse may also occur.

If everyone with vaginitis had exactly these symptoms, then the diagnosis would be fairly simple. However, it is important to realize that as many as 4 out of every 10 women with vaginitis may not have these typical symptoms.

Frequently, a routine gynecologic exam will confirm vaginitis even if symptoms are not present. For this reason, it is important to have a gynecologic exam at regular intervals.

Treatment

The key to proper treatment is proper diagnosis. Because the causes are varied, the medication prescribed may involve antifungal creams and suppositories, antibiotics, and other prescription drugs. Vaginal creams and vaginal applications are often recommended first rather than oral medication.

Common medications used include Flagyl (metronidazole), doxycycline, azithromycin, Diflucan, and over-the-counter yeast medications.

Some self-care techniques include vinegar douches or sitz baths in a solution of 1 teaspoon of vinegar for every gallon of water, and eating yogurt containing live acidophilus cultures. Sstudies have not proven whether or not these are effective.

Recurrent yeast infections (greater than 4 episodes per year) are sometimes treated with oral fluconazole (Diflucan) and itraconazole Sporanox), or vaginal clotrimazole (Mycelex, Gyne-Lotrimin, Femcare) for 6 months.

It is recommended to abstain from sexual intercourse until treatment is completed.

Questions

What is the cause of the vaginitis?

Will you prescribe any medication?

Will the infection recur? How can it be prevented?

Will a prescription be needed if the infection recurs? Are over-the-counter preparations satisfactory?

Prevention

A number of simple habits can help minimize the risks of infection:

  • Keep the vaginal area clean and dry
  • Avoid excessive douching and strong soaps and detergents
  • Wear cotton underwear that absorbs moisture and keeps the vagina dry
  • Clean from front to back after a bowel movement
  • Do not leave tampons or diaphragms in the vagina for long periods
  • Avoid deodorized tampons
  • Decrease intake of sweets, bread, and alcohol
  • Eat yogurt or take acidophilus tablets, especially if you are taking antibiotics