Vaginal Itching, Discharge and Infection: Causes, Evaluation and Care

What it involves

MedlinePlus defines vaginitis, also called vulvovaginitis, as an inflammation or infection of the vagina that can also affect the vulva. It can cause itching, pain, discharge and odor, and it is common in women in their reproductive years. It usually happens when the balance of bacteria or yeast normally found in the vagina changes. Different types have different causes, symptoms and treatments.

Who this is for

• Women with vaginal itching, burning or soreness that has not cleared on its own.
• Patients who notice a new odor or a change in the color or amount of discharge.
• Anyone with symptoms that keep coming back after treating with an over-the-counter product.
• Women who have symptoms after a new partner, antibiotics, or a change in soap or hygiene products.

What to expect

• Questions about your symptoms, when they began, new products or partners, and recent antibiotics
• A pelvic exam and a look at the discharge, with a sample of vaginal fluid studied under a microscope when needed
• Urine or lab tests to check for a urinary or sexually transmitted cause when the symptoms point there
• A treatment plan that fits the cause, and advice on preventing a repeat

Three common causes, three different treatments

MedlinePlus says bacterial vaginosis (BV) is the most common vaginal infection in women ages 15 to 44 and comes from an imbalance of bacteria. Yeast infections happen when too much candida grows, and trichomoniasis is a common sexually transmitted infection caused by a parasite. Allergy or sensitivity to sprays, douches, spermicides, soaps and detergents can also cause burning, itching and discharge, and so can hormone changes in pregnancy, breastfeeding or after menopause. The cause is not always one thing.

What each one tends to look like

According to MedlinePlus, BV may cause no symptoms, or a thin white or gray discharge with a strong fish-like odor, especially after sex. A yeast infection usually brings a thick white discharge that can look like cottage cheese, plus itching and redness. Trichomoniasis may cause no symptoms, or itching, burning, soreness, burning with urination and a gray-green discharge that may smell bad. Because these overlap, guessing from a description is unreliable, which is why an exam helps.

Why not simply treat it yourself

MedlinePlus notes that yeast infection treatments can be bought without a prescription, but you need to be sure you really have a yeast infection and not another type of vaginitis. It advises seeing a provider for a first episode and calling before using an over-the-counter product, even if you have had one before. Treating the wrong problem delays the right one. The STI testing guide explains when a sexually transmitted cause is worth checking.

How a provider finds the cause

MedlinePlus says a provider may ask about your medical history, do a pelvic exam, look at the discharge for color, qualities and odor, and study a sample of vaginal fluid under a microscope. In some cases more tests are needed. Burning with urination can also come from a bladder problem, and the urinary tract infection guide and urinalysis guide explain how that is checked. Diabetes can make yeast infections more likely, as the high blood sugar guide describes.

Treatment and prevention

Treatment depends on the type. MedlinePlus says BV is treated with antibiotics as pills, cream or gel, yeast infections with a cream or medicine placed in the vagina, and trichomoniasis with a single-dose antibiotic, with partners treated to prevent reinfection. A product allergy is treated by finding and stopping the product, and hormone-related irritation may be treated with estrogen cream. To help prevent it, do not douche or use vaginal sprays, use a latex condom, avoid clothes that hold in heat and moisture, and wear cotton underwear.

Sources

• MedlinePlus: Vaginitis (health topic)
• MedlinePlus: Vaginal Diseases (health topic)