Vaginitis: Key Q&A

Reviewed By:
Marc Kaufman, M.D., ACOG

What causes vaginitis?

Vaginitis is the medical term for inflammation or infection of the vagina, or birth canal. It typically occurs when there is an infection or a decrease in the acidity, and therefore an increase in pH level, of the vagina. In premenopausal women, the normal pH level of the vagina is approximately 4.0 on the 0.0 to 14.0 pH scale, which goes from acidic at the low end to alkaline at the high one. The vagina's acidity normally limits the development of infectious bacteria, fungi and parasites.

Vaginitis may also result from reduced levels of estrogen occurring after menopause.

Is there more than one type of vaginitis?

There are several types of vaginitis. The three most common types are bacterial vaginosis, yeast infection and trichomoniasis. Bacterial vaginosis is caused by an overgrowth of one of several bacteria that are usually present in the vagina. Yeast infections are caused by an overabundance of candida, a microscopic fungus that normally inhabits the vagina. Trichomoniasis is caused by a parasite in the vagina, typically Trichomonas vaginalis.

How common is vaginitis?

Almost 75 percent of all adult women will have a yeast infection at some point in their lives, according to the U.S. Centers for Disease Control and Prevention (CDC), and approximately 5 percent of patients will develop a condition called recurrent vulvovaginal candidiasis. Recurrent vulvovaginal candidiasis is classified as more than three symptomatic vaginal yeast infections over the course of one year. Bacterial vaginosis is even more common than yeast infections, although it is not as well understood. Trichomoniasis affects approximately 5 to 10 percent of women in the United States.

Does race affect vaginitis?

Yes. Race is a significant risk factor for bacterial vaginosis: African American women are three times more likely to develop the condition than other women, although the reason for this disparity remains unclear.

Can vaginitis affect pregnancy?

Yes, especially certain types of vaginitis. According to the CDC, bacterial vaginosis affects up to 16 percent of expectant mothers in the United States, though many are not even aware they have the condition. Pregnant women with bacterial vaginosis are at increased risk of premature delivery, postpartum infection and complications following a Caesarean section delivery.

What are the symptoms of vaginitis?

Different types of vaginitis have different symptoms; however, there are some symptoms common to all types of vaginitis. For instance, there may be a change in the color or odor of your vaginal discharge. There may also be a change in the amount of your vaginal discharge. The mucous membranes inside or around your vagina may itch, burn or both. You may experience pain during vaginal intercourse or urination. In addition, a small amount of vaginal bleeding that is not associated with menstruation may occur.

Does treatment for vaginitis affect sexual activity?

During treatment for bacterial vaginosis, women may be advised to refrain from sexual intercourse or ask male partners to use condoms. The male sexual partner of a woman who is undergoing treatment for bacterial vaginosis does not need to go through treatment himself. This is because various studies have found that treating the male sexual partner does not help prevent reinfection.

Women may also be advised to refrain from sexual intercourse while being treated for a yeast infection. Treatment can last anywhere from 1 to 14 days. Yeast infections generally respond to treatment within a few days. The male sexual partners of women with yeast infections do not need to undergo treatment unless they experience symptoms indicative of infection (e.g., redness, irritation and/or itching at the tip of the penis). In such cases, they will need to be treated with an antifungal cream or ointment.

Women who are being treated for trichomoniasis should refrain from sexual activity. To prevent reinfection, it is crucial that male sex partners also be treated for the sexually transmitted disease. Sexual contact should be avoided until both partners are treated.