Vaginitis Health Article

Definition

Vaginitis is a condition characterized by inflammation of the vagina and vulva, most often caused by a bacterial, fungal, or parasitic infection.

Description

Vaginitis, vulvitis, and vulvovaginitis are general terms that refer to the inflammation of the vagina and/or vulva (the external genital organs of a woman). These conditions can be caused by bacterial, fungal, or parasitic infections; or by any type of allergic or irritation reaction to such things as spermicidal products, condoms, soaps, and bubble bath. A type of vaginitis that is caused by a low estrogen level is called atrophic vaginitis.

In general, vaginitis causes one or more of these symptoms: vaginal discharge; irritation; a burning sensation; and itching. One of the most common reasons women visit their doctor is because of a change in their vaginal discharge. It is completely normal for a woman to have a vaginal discharge, with the amount and consistency varying during the course of the menstrual cycle. The three most common types of vaginitis are bacterial vaginosis, candida vulvovaginitis, and trichomoniasis. Each will be discussed separately.

Bacterial vaginosis

Bacterial vaginosis is the most common cause of vaginitis during the childbearing years. Forty percent to 50% of vaginitis cases are caused by bacterial vaginosis. The occurrence of bacterial vaginosis is difficult to determine, but studies have proposed that 10–41% of women have had it at least once. The occurrence of bacterial vaginosis in the United States is highest among African-American women and women who have had multiple sexual partners, and is lowest among Asian women and women with no history of sexual contact with men. Bacterial vaginosis is not considered a sexually transmitted disease although it can be acquired through sexual intercourse. Recent findings indicate that bacterial vaginosis can be transmitted among women who have sex only with women, if vaginal secretions are exchanged.

Bacterial vaginosis is not caused by a particular organism but by a change in the balance of normal vaginal bacteria or by a change in the pH balance. Ninety percent of the bacteria found in a healthy vagina belong to the genus Lactobacillus. For various reasons, there is a shift in the bacterial population that results in overgrowth of other bacteria. Patients suffering from bacterial vaginosis have very high numbers of such bacteria as Gardnerella vaginalis, Mycoplasma hominis, Bacteroides species, and Mobiluncus species; and these bacteria can be found at numbers 100–1,000 times greater than are found in the healthy vagina. In contrast, Lactobacillus bacteria are very low in number or completely absent from the vagina of women with bacterial vaginosis.