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Vulvovaginitis

Vaginitis; Vaginal inflammation; Inflammation of the vagina; Nonspecific vaginitis

Vulvovaginitis or vaginitis is swelling or infection of the vulva and vagina.

Vaginitis is a common problem that can affect women and girls of all ages.

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Female perineal anatomy

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Causes

INFECTIONS

Yeast infections are one of the most common causes of vulvovaginitis in women.

The vagina normally contains both healthy bacteria and unhealthy bacteria. Bacterial vaginosis (BV) occurs when more unhealthy bacteria than healthy bacteria grow. BV may cause a thin, gray vaginal discharge, pelvic pain, and a fishy odor.

A less common type of vaginitis is spread by sexual contact. It is called trichomoniasis. Symptoms in women include genital itching, vaginal odor, and a heavy vaginal discharge that may be yellow-gray or green in color. Women may also experience vaginal spotting after intercourse.

OTHER CAUSES

Chemicals can cause itchy rashes in the genital area.

Low estrogen levels in women after menopause can cause vaginal dryness and thinning of the skin of the vagina and vulva. These factors may lead to or worsen genital itching and burning.

Other causes include:

Sometimes, the exact cause cannot be found. This is called nonspecific vulvovaginitis.

Irritated tissue is more likely to become infected than healthy tissue. Many germs that cause infection thrive in a warm, damp, and dark environment. This can also lead to a longer recovery.

Sexual abuse should be considered in young girls with unusual infections and repeated episodes of unexplained vulvovaginitis.

Symptoms

Symptoms include:

Exams and Tests

If you have had a yeast infection in the past and know the symptoms, you can try treatment with over-the-counter products. However, if your symptoms do not completely go away in about a week, contact your health care provider. Many other infections have similar symptoms.

The provider will perform a pelvic examination. This exam may show red, tender areas on the vulva or vagina.

A wet prep is usually done to identify a vaginal infection or overgrowth of yeast or bacteria. This includes examining vaginal discharge under a microscope. In some cases, a culture of the vaginal discharge may help find out the germ that is causing the infection.

A biopsy (a test of the tissue) of the irritated area on the vulva may be done if there are no signs of infection.

Treatment

Creams or suppositories are used to treat yeast infections in the vagina. You can buy most of them over-the-counter. Follow the directions that came with the medicine you are using.

There are many treatments for vaginal dryness. Before treating your symptoms on your own, see a provider who can find the cause of the problem.

If you have BV or trichomoniasis, your provider may prescribe:

Other medicines that may help include:

Be sure to use the medicine exactly as prescribed and follow the instructions on the label.

Outlook (Prognosis)

Proper treatment of an infection is effective in most cases.

When to Contact a Medical Professional

Call your provider if:

Prevention

Keep your genital area clean and dry when you have vaginitis.

Avoid douching. Many women feel cleaner when they douche, but it may actually make symptoms worse because it removes healthy bacteria that line the vagina. These bacteria help protect against infection.

Other tips are:

Allow more air to reach your genital area. You can do this by:

Girls and women should also:

Always practice safe sex. Use condoms to avoid catching or spreading infections.

Related Information

Allergen
Vagina
Vaginal dryness

References

Abdallah M, Augenbraun MH, McCormack WM. Vulvovaginitis and cervicitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 108.

Braverman PK. Urethritis, vulvovaginitis, and cervicitis. In: Long SS, Prober CG, Fischer M, eds. Principles and Practice of Pediatric Infectious Diseases. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 51.

Gardella C, Eckert LO, Lentz GM. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 23.

Oquendo Del Toro HM, Hoefgen HR. Vulvovaginitis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 564.

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Review Date: 6/3/2020  

Reviewed By: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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