Vulvovaginitis

Written by Kati Blake | Published on 26 July 2012
Medically Reviewed by Jennifer Wider, MD

What Is Vulvovaginitis?

Vulvovaginitis is inflammation or infection of the vulva and vagina. It is a common condition affecting women and girls of all ages. It has a variety of causes. It may also be called vulvitis or vaginitis.

What Causes Vulvovaginitis?

Vulvovaginitis can be caused by many things, including:

  • bacteria
  • yeasts
  • viruses
  • parasites
  • environmental factors
  • allergens
  • sexually transmitted infections
  • chemicals
  • menopause

Bacteria

Overgrowth of certain bacteria can cause Vulvovaginitis. These bacteria include Streptococcus, Gardnerella, and Staphylococcus. A bacterial infection typically causes a grayish-white discharge that smells fishy. However, about half of women with this type of infection have no symptoms (njfamilyhivaids.org).

Yeasts

One of the most common causes of vulvovaginitis is Candida albicans. This yeast infection typically causes genital itching and a thick, white vaginal discharge. A yeast infection often follows use of antibiotics. Antibiotics can kill the antifungal bacteria that normally live in the vagina. This can lead to yeast infection.

Viruses

Viruses that can cause vulvovaginitis include herpes simplex and human papillomavirus (HPV).

Parasites

Pinworms, scabies, and lice can cause inflammation of the vulva and vagina.

Environmental Factors

Poor hygiene and allergens can cause this condition. Tight clothing can rub against the skin and create irritation. Irritated skin is more susceptible to vulvovaginitis than normal skin. Irritation can also delay recovery.

Sexually Transmitted Infections

Vulvovaginitis can be caused by the sexually transmitted infection trichomonas vaginitis. This causes genital discomfort, itching, and a heavy discharge. This discharge can be yellow, green, or gray. It often has a strong odor. Chlamydia, gonorrhea, and herpes can also cause vaginitis. These infections in a child might indicate abuse. However, some of these can be transmitted to a child without sexual contact.

Chemicals

Some chemicals can cause vulvovaginitis. These are often found in:

Menopause

Postmenopausal women have a lower level of estrogen. This can cause vaginal dryness and thinning of the skin around the genitals. This irritation and thinning can make women more susceptible to itching and burning.

Nonspecific Vulvovaginitis

Sometimes vulvovaginitis has no known cause. It is frequently diagnosed in young girls who have not yet begun puberty. Doctors believe this is due to low estrogen. When puberty begins, the vagina becomes more acidic, and the infections usually stop.

What Are the Symptoms of Vulvovaginitis?

The symptoms of vulvovaginitis vary, depending on the cause.

In general, symptoms include:

  • irritation of the genital area
  • genital itching
  • inflammation, specifically around the labia and perineal areas
  • foul odor that is typically quite strong
  • increased vaginal discharge
  • discomfort when urinating, including burning

How Is Vulvovaginitis Diagnosed?

A doctor will diagnose vulvovaginitis by discussing your symptoms and possibly collecting a sample of vaginal discharge to test.

In some cases, the doctor may need to perform a pelvic examination. A wet prep may be necessary in order to correctly identify the cause of your inflammation. This involves collecting some vaginal discharge for microscopic evaluation. Typically this will identify the organism and make treatment both quicker and more successful.

In rare cases, it may be necessary to biopsy the vulva in order to identify the organism. This means the doctor will take a small sample of tissue for further examination. A biopsy is typically only necessary if there is no sign of irritation.

How Is Vulvovaginitis Treated?

The correct treatment for vulvovaginitis depends on the type of infection and the organism causing the problems. It is possible to self-treat some types of vulvovaginitis. However, you should speak with a healthcare provider before initiating any treatment.

Self-Treatment

Perhaps you have been diagnosed with a yeast infection in the past. In this case, you may be able to treat vulvovaginitis using over-the-counter yeast products. A pharmacist will be able to advise you on the best product for your symptoms and how to apply the product. Consult your doctor if the inflammation is not better after a week.

Prescribed Medications

Once your doctor has identified the type of organism causing your vulvovaginitis, he or she will prescribe medication to cure the condition.

This could include:

  • oral antibiotics
  • antibiotic creams applied directly to the infected skin
  • antifungal creams applied directly to the skin
  • antibacterial creams applied directly to the skin
  • cortisone creams
  • oral antihistamines, if an allergic reaction is a possibility
  • estrogen creams

Your doctor may also recommend a personal hygiene routine to help heal the infection and prevent it from recurring. This could include sitz baths and wiping properly after using the toilet.

Other suggestions include wearing loose clothing and cotton underwear to allow the circulation of air and reduce moisture. Removing underwear at bedtime may also help.

Proper cleansing is important and may help prevent irritation. This is especially true if the infection is bacterial. Sitz baths may be recommended by your healthcare provider. It is also advisable to avoid using bubble bath, perfumed soaps, and washing powders as much as possible. You may find sensitive-skin versions of these products less irritating.

A cold compress can be used to relieve pain on swollen or tender areas.

Sexually Transmitted Infections

It is important to alert your sexual partners if your vulvovaginitis is caused by an STI. All sexual partners should receive treatment for the condition. This is true even if they are not currently showing symptoms.

It is important not to have sexual contact with anyone who currently has the condition. This is true whether the affected person is still being treated or has not been treated.

What Is the Outlook for Vulvovaginitis?

Most cases of vulvovaginitis will heal quickly when properly treated. Return to the doctor if you do not see an improvement in the condition within one week. You may find alternative treatments are more effective.

f your vulvovaginitis is caused by yeast, you may find the infection returns infrequently. This can usually be treated with over-the-counter products.

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Article Sources:

  • Trowbridge, J. P., & Walker, M. (1986). The yeast syndrome. Toronto: Bantam Books.
  • Vaginitis: Signs, symptoms & diagnosis. (n.d.) Njfamilyhivaids.org. Retrieved July 28, 2012, from http://www.njfamilyhivaids.org/vaginitis-symptoms.htm
  • Vulvovaginitis. (2010, June 5). University of Maryland Medical Center. Retrieved July 23, 2012, from http://www.umm.edu/ency/article/000897trt.htm
  • Vulvovaginitis in the prepubertal child. (n.d.) The University of Chicago Pritzker School of Medicine Pediatrics Clerkship. Retrieved July 23, 2012, from http://pedclerk.bsd.uchicago.edu/vulvovaginitis.html

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