Vaginal discharge, itching, and burning are common symptoms of various types of vaginitis. Although the symptoms of these infections can be very similar, there are some differences to look for in the color and smell of the discharge.
Some vaginal discharge is quite common and normal for women of childbearing age. Normally, cervical glands produce a clear mucous secretion that drains downward, mixing with bacteria, discarded vaginal cells, and Bartholin's gland secretions near the opening of the vagina. These substances may (depending on how much mucus there is) turn the mucus a whitish color, and the discharge turns yellowish when exposed to air. There are times during the menstrual cycle when the cervical glands produce more mucus than others, depending on the amount of estrogen produced. This is normal.
Sexual excitement and emotional stress have both been associated with an increase in normal physiologic vaginal discharge. This discharge is frequently clear and watery in consistency.
If your vaginal discharge is abnormal in color such as green, has a foul smell, changes consistency, or is significantly increased or decreased in amount, you may be developing a form of vaginitis.
Pain itself is not a frequent symptom of vaginal infections (except for the itching) and should prompt you to see your health care practitioner.
Bacterial vaginosis (BV) is the most common cause of vaginitis. Bacterial vaginosis is caused by a change or imbalance in the types of the bacteria normally found in the vagina and causes an overgrowth of organisms such as Gardnerella vaginalis.
Vaginal yeast infections are caused by a fungus, mainly by Candida albicans. This is also called candidiasis, genital candidiasis, or vulvovaginal candidiasis (VVC). Yeast infection can spread to other parts of the body including skin, mucous membranes, heart valves, esophagus, and other areas. In rare circumstances, it can cause life-threatening systemic infections mostly in people with weakened immune defenses (such as women who are pregnant and people who are HIV positive, have diabetes, or are taking steroids).
A majority of adult women have had at least one genital yeast infection in their lifetime. Vaginal yeast infection is not considered a sexually transmitted disease, but some men will develop symptoms such as itching and penile rash following sexual contact with an infected partner.
Yeast infections are caused by an overgrowth of normally growing fungi in the vagina that creates unpleasant symptoms. The yeast are normally kept under control by naturally occurring bacteria in the body. If the natural balance of microorganisms is disrupted, the yeast grow out of control. It is not clear how fungal infections originate, but they are not thought to be sexually transmitted. Infections tend to happen when an imbalance occurs, possibly caused by any of these events:
Trichomoniasis is a sexually transmitted disease (also called trich, pronounced "trick") caused by the parasite Trichomonas vaginalis. Trichomoniasis is primarily an infection of the urinary and genital tract. For women, the vagina is the most common site of infection. For men, the urethra is most commonly affected.
Other causes of vaginal inflammation may be allergies to spermicides, vaginal hygiene products, and detergents and fabric softeners. Another type of sexually transmitted disease may be present. Older women may experience atrophic vaginitis (a thinning of the vaginal walls with menopause). Foreign objects such as a forgotten tampon or another foreign object may cause vaginal irritation.
You should seek medical care any time if you experience vaginal pain. Although vaginal infections may cause unpleasant itching, they should not cause pain.
Call for an appointment with your healthcare professional if this is the first time that vaginal yeast infection symptoms have occurred, or if you are unsure if you have a yeast infection or another type of vaginal infection. (If you think you have a yeast infection, you can treat the disorder with over-the-counter medications.) If your symptoms do not respond to one course of over-the-counter medications, you may not have a yeast infection and you should see your doctor.
Vaginal yeast infections, although uncomfortable, are usually not life-threatening. You should see your healthcare professional if you have any of the following:
Other pelvic conditions with symptoms similar to vaginal yeast infections need to be checked by a health care practitioner in a hospital's emergency department. Seek medical care if the following conditions develop:
Your health care practitioner will ask about your symptoms and perform a physical exam. Urine tests and samples of any discharge will likely be done.
You may be asked questions including the following:
During the pelvic examination, the doctor will inspect your vagina and cervix for any discharge or lesions. The doctor will determine the size and location of the uterus and cervix. The doctor will assess if you have pain or tenderness on the movement of the cervix and uterus, or in the areas next to the uterus, which corresponds to the Fallopian tubes and ovaries.
During the vaginal examination, a speculum is introduced into the vagina to see the cervix. Swabs will be taken of any discharge to determine if the infection is fungal (yeast), protozoan (trichomoniasis), or bacterial (bacterial vaginosis). Your health care provider can examine a sample of vaginal discharge under a microscope to detect the presence of the organisms associated with vaginal infections.
If you are diagnosed with vaginitis, keep your genital area clean and dry. Don't douche or use feminine hygiene sprays or powders while being treated. Don't have sexual relations while being treated.
After visiting your physician, abstain from sexual intercourse until treatment is completed and symptoms subside.
Diagnosis is usually made based on your symptoms and results of urine tests and, occasionally, vaginal cultures (samples sent to the lab). Treatment is based on the organism causing the infection.
Depending on the cause of the infection, your health care practitioner may prescribe vaginal suppositories, antifungal pills, or antibiotics (as pills or an injection). Treatment varies depending on which form of vaginitis you have, the severity of infection, duration of infection, recurrence of infection, and whether you are pregnant.
Follow up with your doctor for results of your cervical lab tests and Pap test. It is recommended that you have a complete physical examination every year, whether or not you are experiencing any symptoms.
Bacterial vaginosis and trichomoniasis will not go away with home care or over-the-counter medications. They require antibiotics. You must see your healthcare professional for diagnosis and treatment.
Only yeast infections may respond to over-the-counter medications. If you have never had a yeast infection and think you have one, it is important that your healthcare provider agrees with this diagnosis before you try any home care techniques or over-the-counter medications. Generally, the first incidence of yeast infection should be treated by your health care provider.
Bacterial vaginosis: Your healthcare professional may treat you with antibiotics such as metronidazole (Flagyl) or clindamycin (Cleocin). Generally, male sex partners are not treated. Many women with symptoms of bacterial vaginosis do not seek medical treatment, and many women without symptoms decline treatment. This condition may resolve spontaneously in up to one-third of cases in non-pregnant patients and up to half in pregnant patients.
Yeast infection: If this is the first time you have had a yeast infection, a doctor should be consulted before trying any home remedies or over-the-counter products. Your doctor will usually recommend that you use vaginal creams and vaginal applications rather than oral medication. Pregnant women usually will be treated longer than non-pregnant women and be closely monitored.
Trichomoniasis: Trichomoniasis is treated with metronidazole. It usually is given in a single dose. If you take this drug, do not drink alcohol because mixing the two substances occasionally can cause severe nausea and vomiting. Both sex partners are treated with the medicine even if they do not have signs of the disease.
Because the bacterial balance of the vagina is very sensitive, it is best to let the vagina clean itself. The vagina takes care of cleaning itself naturally through secretions of mucus. Warm water and gentle, unscented soap during the bath or shower is the best way to clean the outside areas of the vagina. Products like feminine hygiene soaps, powders, and sprays are not necessary, and they may be harmful.
Douching refers to rinsing or cleaning out the vagina by squirting water or other solutions (such as vinegar, baking soda, or douching solutions you can buy at drug and grocery stores) into the vagina. The water or solutions are held in a bottle and squirted into the vagina through the tubing and a nozzle. Although douching is a common practice among women in the United States, health care providers do not recommend douching to clean the vagina. Douching changes the delicate balance in the vagina, which can make you more likely to develop a vaginal infection. Research shows that women who douche regularly tend to have more vaginal infections than women who do not douche or who rarely douche.
Douching is not a form of birth control, and douching after sex does not prevent pregnancy.
The best ways to prevent bacterial vaginosis are not known. However, enough is known to show that bacterial vaginosis is associated with having a new sex partner or having multiple sex partners. It is seldom found in women who have never had intercourse. Basic prevention would include using condoms, limiting the number of sex partners, abstaining from douching, and using all the medicine prescribed for the treatment of bacterial vaginosis, even if the symptoms go away.
In most cases, vaginal yeast infections can be easily prevented.
Trichomoniasis can be prevented as well. If you are diagnosed with a trichomonal infection, your sex partner should also be checked. He or she may have other sexually transmitted diseases and also may re-infect you if not treated. Safe sex with condoms and counseling about sexually transmitted diseases are in order.
If diagnosed and treated correctly, all forms of vaginitis usually respond well to therapy. Your symptoms will clear up and go away. If your symptoms do not resolve or the symptoms return, you must be reevaluated by your health care professional.
Vaginal discharge may range in color from clear to gray, yellow, greenish, or milky-white and may have an unpleasant smell. The symptoms and character of vaginal discharge depend upon the specific condition that is the cause of the discharge.