Vaginal Infections
Infection or inflammation of the vagina
Quick Facts
- Type: Vaginal (gynecologic) condition
- Common types: Yeast infection, bacterial vaginosis, trichomoniasis
- Common signs: Discharge changes, itching, irritation, odor
- Treatment: Depends on the cause; antifungal or antibiotic
Overview
Vaginal infections, often grouped under the term vaginitis, are infections or inflammation of the vagina that lead to symptoms such as abnormal discharge, itching, burning, irritation, or odor. They are very common and usually not serious, but they can be uncomfortable and sometimes signal a condition that needs specific treatment.
The healthy vagina contains a natural balance of bacteria and other microbes. When this balance is disturbed, certain organisms can overgrow or new ones can take hold, leading to infection. The three most common causes are yeast infections, bacterial vaginosis, and trichomoniasis. Because their symptoms can overlap, it is often helpful to have the cause confirmed so the right treatment is used.
Symptoms
Symptoms vary depending on the cause but commonly include:
- A change in the amount, color, or consistency of vaginal discharge
- Itching or irritation in or around the vagina
- Burning, especially during urination
- An unusual or strong vaginal odor
- Redness and swelling of the vulva
- Discomfort or pain during sex
Different infections have somewhat different patterns: yeast infections often cause thick, white discharge and intense itching; bacterial vaginosis tends to cause a thin, grayish discharge with a noticeable odor; and trichomoniasis can cause frothy, yellow-green discharge and irritation. Symptoms such as fever, pelvic pain, or sores may point to a different or more serious problem and should be checked by a clinician.
Causes
The most common causes of vaginal infections are:
- Yeast infection: Overgrowth of a fungus called Candida that normally lives in small amounts in the vagina.
- Bacterial vaginosis: An imbalance in the normal vaginal bacteria, with a decrease in protective bacteria.
- Trichomoniasis: A sexually transmitted infection caused by a tiny parasite.
Other causes of vaginal irritation include reactions to soaps, douches, or products (a non-infectious vaginitis), and thinning of the vaginal lining after menopause. Several things can disturb the vaginal balance, including antibiotics, hormonal changes, and certain hygiene practices.
Risk Factors
- Recent use of antibiotics
- Hormonal changes from pregnancy, menstrual cycle, or menopause
- Uncontrolled diabetes
- Douching or using scented hygiene products
- Sexual activity, which is relevant for trichomoniasis
- A weakened immune system
- Wearing damp or tight clothing for long periods
Diagnosis
Because symptoms of the different infections overlap, a clinician often confirms the cause before treatment:
- Medical history: Asking about symptoms, sexual activity, recent antibiotics, and previous infections.
- Pelvic examination: Looking at the vulva, vagina, and discharge.
- Sample testing: Examining a sample of vaginal discharge under a microscope, checking its acidity, and using laboratory tests to identify yeast, bacterial vaginosis, or trichomoniasis.
- STI testing: When trichomoniasis or other sexually transmitted infections are a concern.
Treatment
Treatment is directed at the specific cause:
- Yeast infections: Antifungal medications as creams, suppositories, or pills.
- Bacterial vaginosis: Antibiotics taken by mouth or applied as a gel or cream.
- Trichomoniasis: Antibiotic medication, with treatment of sexual partners to prevent reinfection.
- Non-infectious vaginitis: Avoiding the irritant or, after menopause, treatments to restore the vaginal lining.
It is best to confirm the cause rather than assume, because treating the wrong condition may not help and can delay relief. Recurrent or persistent infections should be evaluated by a clinician, who may recommend a longer or different course of treatment.
Prevention
- Avoid douching, which disrupts the natural vaginal balance
- Avoid scented soaps, sprays, and harsh hygiene products in the genital area
- Wear breathable cotton underwear and change out of wet clothing promptly
- Wipe from front to back after using the toilet
- Manage diabetes and overall health
- Use condoms to lower the risk of sexually transmitted infections like trichomoniasis
When to See a Doctor
See a clinician if you have vaginal symptoms for the first time, if symptoms are severe, or if they do not improve with treatment. Also seek care if you have:
- Recurrent infections
- Fever, chills, or pelvic or lower abdominal pain
- Sores, blisters, or unusual bleeding
- Symptoms during pregnancy
- A new sexual partner or concern about a sexually transmitted infection
A clinician can confirm the cause and recommend the right treatment, which is especially important when symptoms keep returning or are not clearly a simple yeast infection.
Frequently Asked Questions
What are the most common types of vaginal infection?
The three most common are yeast infections, bacterial vaginosis, and trichomoniasis. Their symptoms can overlap, so a clinician often confirms the cause with an examination and testing before recommending treatment.
How can I tell which infection I have?
It can be hard to tell on your own, because symptoms overlap. Yeast infections often cause thick white discharge and itching, bacterial vaginosis a thin grayish discharge with odor, and trichomoniasis a frothy discharge with irritation. Testing gives the most reliable answer.
Can I treat a vaginal infection with over-the-counter medicine?
Over-the-counter antifungal products can treat yeast infections, but they will not help bacterial vaginosis or trichomoniasis, which need antibiotics. If you are unsure of the cause, have symptoms for the first time, or do not improve, see a clinician.
Are vaginal infections sexually transmitted?
Some are and some are not. Trichomoniasis is sexually transmitted, while yeast infections and bacterial vaginosis are usually due to a change in the vagina's natural balance rather than sexual contact, although sexual activity can play a role.
When should I see a doctor for vaginal symptoms?
See a clinician for first-time symptoms, severe or recurrent infections, symptoms that do not improve with treatment, or if you have fever, pelvic pain, sores, unusual bleeding, or symptoms during pregnancy. Confirming the cause ensures the right treatment.
References
- Office on Women's Health, U.S. Department of Health and Human Services. Vaginitis.
- Centers for Disease Control and Prevention (CDC). Bacterial vaginosis and trichomoniasis.
- Mayo Clinic. Vaginitis.
- MedlinePlus, U.S. National Library of Medicine. Vaginitis.