Gynaecologic Problems: Vaginitis

Vaginitis is a medical term that is used to refer to any infection or inflammation of the vagina, characterised by discharge, odor, irritation, and/or itching.
Vulvovaginitis refers to inflammation of both the vagina and vulva (the external female genitals).
The most common kinds of vaginitis are bacterial vaginosis (BV), yeast , and trichomoniasis .

  Types of Vaginitis

1. Vaginal Yeast Infections

Vaginal yeast infection or vulvovaginal candidiasis is a common cause of vaginal irritation. Doctors estimate that approximately 75 percent of all women will experience at least one symptomatic yeast infection during their lifetimes. Yeast are always present in the vagina in small numbers, and symptoms only appear with overgrowth. Several factors are associated with increased symptomatic infection in women, including pregnancy , uncontrolled diabetes mellitus , and the use of oral contraceptives or antibiotics. Other factors that may increase the incidence of yeast infection include using douches, perfumed feminine hygiene sprays, and topical antimicrobial agents, and wearing tight, poorly ventilated clothing and underwear. Whether or not yeast can be transmitted sexually is unknown. Because almost all women have the organism in the vagina, it has been difficult for researchers to study this aspect of the natural history.
The most frequent symptoms of yeast infection in women are itching, burning, and irritation of the vagina. Painful urination and/or intercourse are common. Vaginal discharge is not always present and may be minimal. The thick, whitish-gray discharge is typically described as cottage-cheese-like in nature, although it can vary from watery to thick in consistency.
Since few specific signs and symptoms are usually present, this condition cannot be diagnosed by the patient's history and physical examination. The doctor usually diagnoses yeast infection through microscopic examination of vaginal secretions for evidence of yeast forms.
Various antifungal vaginal medications (which include creams, tablets and suppositories) are available to treat yeast infection. [ 1 ]

2. Bacterial Vaginosis

Bacterial vaginosis (BV) is the most common cause of vaginitis symptoms among women of childbearing age. Previously called nonspecific vaginitis or Gardnerella -associated vaginitis, BV is associated with sexual activity. BV reflects a change in the vaginal ecosystem. This imbalance, including pH changes, occurs when different types of bacteria outnumber the normal ones.
The primary symptom of BV is an abnormal, odorous (often described as 'fish-like') vaginal discharge. The odor is noticeable especially after intercourse. Nearly half of the women with clinical signs of BV, however, report no symptoms. A physician may observe these signs during a physical examination and may confirm the diagnosis by doing tests of vaginal fluid.
Treatment is usually with antibiotics such as metronidazole or clindamycin.
Complications of BV may include pelvic inflammatory disease (PID). BV is also associated with increased risk of gonorrhea and HIV infection. [ 1 ]

3. Trichomoniasis

Description

Trichomoniasis, is a common Sexually Transmitted Disease (STD) caused by a single-celled protozoan parasite called Trichomonas vaginalis . Trichomoniasis is primarily an infection of the urogenital tract. The urethra is the most common site of infection in men, while the vagina is the most common site of infection in women.
Although previously trichomoniasis was not thought to result in any important complications, data now suggest that trichomoniasis may increase the risk of transmission of human immunodeficiency virus (HIV), the virus that causes AIDS, and may cause delivery of low-birth-weight or premature infants . However, additional research is needed to fully explore these relationships.

Symptoms and Signs

Trichomoniasis, like many other STDs, often occurs without any symptoms. When symptoms occur, they usually appear within 4 to 20 days of exposure although symptoms can appear years after infection. The symptoms in women include a heavy, yellow-green or grey vaginal discharge, discomfort during intercourse, vaginal odour, and painful urination. Irritation and itching of the genital area, and on rare occasions, lower abdominal pain also can be present. [ 2 ]

Diagnosis and Treatment

Although symptoms of trichomoniasis in men may disappear within a few weeks without treatment, men can transmit the disease to their sex partners even when symptoms are not present. Therefore, it is preferable to treat both partners to eliminate the parasite. Metronidazole is the drug used to treat trichomoniasis. It is administered in a single dose.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. National Institutes of Health, National Institute of Allergy and Infectious Diseases, Sexually Transmitted Diseases Factsheets: http://www.niaid.nih.gov/publications/stds.htm
2. The National Women's Health Information Center (NWHIC) FAQs: http://www.4woman.gov/faq/