Atrophic Vaginitis

Vaginitis is a common inflammation of the vaginal lining and the vulva, the folds of skin surrounding the vaginal opening. It is often a result of infection by one of various microorganisms, but vaginitis may also be caused by irritation from soaps or medications, an allergic reaction, or hormonal changes. The three most common types of vaginitis are candidiasis (yeast infection)trichomoniasis (infection by a tiny, one-celled organism called a protozoan), and bacterial vaginosis. Although irritating, vaginitis is not a serious health risk, and it typically subsides quickly with treatment. Recurrent or persistent cases may be associated with an underlying medical condition.

What Causes Vaginitis?

  • Bacterial, fungal, or protozoal infections.
  • An allergic reaction to or irritation by substances in spermicides, douches, soaps, or bath oils may produce vaginitis.
  • Infectious chemicals in creams or sprays, viruses, yeast or even clothing can cause vaginitis.
  • Trichomoniasis may be spread through sexual intercourse.
  • Oral corticosteroids, antibiotics, and oral contraceptives may make vaginitis more likely.
  • Certain conditions including pregnancy, malnutrition, poor health and diabetes mellitus carry a greater risk of vaginitis.
  • A decrease in estrogen levels in postmenopausal women may lead to thinning of the vaginal lining, resulting in atrophic vaginitis.

Symptoms of Vaginitis

  • Profuse vaginal discharge. Discharge may be heavy, white, thick, and odorless (candidiasis); greenish yellow, frothy, and foul-smelling (trichomoniasis); white or gray, and fishy-smelling (bacterial vaginosis); thin, white or blood-streaked, and foul-smelling (atrophic vaginitis).
  • Vaginal and vulvar pain or itching. Pain may be worse upon urination and during sexual intercourse.
  • Uncomfortable and irritated
  • Bright reddish color to the vulva

Vaginitis Prevention

  • Shower daily, using a mild, unscented soap in the vaginal area.
  • Avoid using douches.
  • Use condoms during sexual intercourse to help decrease the risk of infection.
  • Wear cotton undergarments and pantyhose with a cotton crotch. Avoid nylon undergarments, which do not breathe. Do not share underwear, towels, or swimsuits.
  • Limit the time spent in using a wet swimsuit.
  • After a bowel movement, wipe from front to back to prevent the bacteria that normally inhabit the anal area from contacting the vagina.
  • Limit using a perfumed shower gels and bubble baths
  • Avoid using scented tampons/maxi-pads.
  • Do not use vaginal douches unless advised to do so by your doctor.
  • Avoid using of mini-pads on non-menstrual days.

Vaginitis Diagnosis

  • Pelvic examination
  • Microscopic examination or a culture of vaginal discharge

How to Treat Vaginitis

  • An antifungal medication such as miconazole or clotrimazole is prescribed in the form of vaginal suppositories or cream to treat candidiasis (yeast infection). These medications are now available over the counter. Oral antifungal medication such as ketoconazole may be prescribed in severe cases that do not respond to topical therapy.
  • Metronidazole, an antimicrobial drug, is administered to both sexual partners for trichomoniasis and should be taken for the full term prescribed. Only one partner may exhibit symptoms, but both should be treated to prevent a perpetual cycle of reinfection.
  • Metronidazole or various antibiotics may be prescribed to treat bacterial vaginosis.
  • Topical or oral estrogens may be prescribed for atrophic vaginitis.
  • If a medication is suspected as the cause of vaginitis, a change in prescription may be warranted.
  • Abstinence from sexual intercourse may be advised until treatment is completed.

When to Call a Doctor

  • Call your gynecologist if you experience vaginal itching, burning, or pain, or if you notice any abnormal vaginal discharge.
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