Vulvovaginitis is an inflammation or infection of the vulva and vagina. It’s a common condition that affects women and girls of all ages. It has a variety of causes. Other names for this condition are vulvitis and vaginitis.
Bacterial vulvovaginitis affects nearly 30 percent of women in the United States during their lifetime, according to the Centers for Disease Control and Prevention (CDC) and is the most common cause of symptoms. A 2017 CDC fact sheet indicates that vaginal candidiasis (yeast infection) is the second most prevalent vaginal infection.
- environmental factors
- sexually transmitted infections (STIs)
- exposure to chemical irritants and allergens
Certain bacteria can multiply and cause vulvovaginitis. These bacteria include Streptococcus, Gardnerella, and Staphylococcus. A bacterial infection can cause a grayish-white discharge with a fishy odor.
One of the most common causes of vulvovaginitis is Candida albicans. This yeast infection can cause genital itching and a thick, white vaginal discharge with a cottage cheese-like texture.
Some women experience yeast infections after using antibiotics. This is because antibiotics can kill the antifungal bacteria that naturally live in the vagina.
Poor hygiene and allergens can also cause this condition. Tight clothing can rub against the skin and create irritation and trap moisture in the area.
Irritated skin is more susceptible to vulvovaginitis than healthy skin. Irritation can also delay recovery.
Sexually transmitted infections (STIs)
The STI trichomonas vaginitis can cause vulvovaginitis. This infection causes genital discomfort, itching, and heavy discharge. The discharge can be yellow, green, or gray. It often has a strong odor. Chlamydia, gonorrhea, and herpes can also cause vaginitis.
Some chemicals can cause vulvovaginitis. These are often found in soaps, feminine sprays, perfume, and vaginal contraceptives. Chemicals that can cause an allergic reaction include:
- sodium sulfate
If any of these ingredients are in your soap or laundry detergent, you may want to switch to a hypoallergenic or fragrance-free brand. This can help prevent your infection from recurring.
Vulvovaginitis is the most common gynecological condition in prepubescent girls. Doctors believe this is due to low estrogen levels. When puberty begins, the vagina becomes more acidic, and the infections usually stop.
Vulvovaginitis in children can be treated with daily bathing, steroids, and low-dose, topical antibiotics. It’s important to advise your child on proper bathroom hygiene. Wearing loose-fitting cotton underwear can keep the infection from occurring again.
The symptoms of vulvovaginitis vary and depend on their cause. In general, symptoms can include:
Your doctor will diagnose vulvovaginitis by discussing your symptoms and possibly collecting a sample of vaginal discharge to test.
In most cases, your doctor will need to perform a pelvic examination. A wet prep may be necessary to correctly identify the cause of your inflammation. This involves collecting some vaginal discharge for microscopic evaluation.
Your doctor can then identify the organism causing the condition, leading to a quicker and more successful treatment.
In rare cases, it may be necessary to biopsy the vulva to identify the organism. This means your doctor will take a small sample of tissue for further examination. A biopsy is typically only necessary if traditional treatment methods are unsuccessful.
The correct treatment for vulvovaginitis depends on the type of infection and the organism causing the problem.
It is possible to treat some types of vulvovaginitis on your own. But be sure to speak with your doctor before initiating any home treatment.
If you’ve had a yeast infection in the past, you may be able to treat vulvovaginitis using over-the-counter products available at any pharmacy, including:
A pharmacist can likely advise you on the best product for your symptoms and how to apply the product.
Crushed garlic and coconut oil, both known for their antibacterial properties, may also help treat the condition.
You may be able to relieve some of the symptoms of your vulvovaginitis by sitting in a sitz bath — a warm, shallow bath that only covers your hip area. Adding tea tree oil or a trace amount of vinegar or sea salt to the bath may help kill some bacteria, if that’s the cause of your symptoms.
Be careful not to sit in the bath for too long. Use a towel to dry the affected area completely after your bath.
Consult your doctor if the inflammation or discharge doesn’t improve after a week of home treatment.
After your doctor identifies the type of organism causing your vulvovaginitis, they’ll likely prescribe medication.
Medications for this condition may include:
- oral antibiotics
- antibiotic creams (applied directly to the skin)
- antibacterial creams (applied directly to the skin)
- antifungal creams (applied directly to the skin)
- oral antifungal pills
- oral antihistamines, if an allergic reaction is a possible cause
- estrogen creams
Your doctor may also recommend a personal hygiene routine to help heal the infection and prevent it from recurring. This could include taking sitz baths and wiping properly after using the toilet.
Other suggestions include wearing loose clothing and cotton underwear to allow for air circulation and to reduce moisture in the area. Removing underwear at bedtime may also help prevent vulvovaginitis.
Proper cleansing is important and may help prevent irritation. This is especially true if the infection is bacterial. Avoid using bubble baths, perfumed soaps, douches, and washing powders. Opt for sitz baths or sensitive-skin versions of products instead.
A cold compress may also relieve pain on swollen or tender areas.
It’s important to alert your sexual partners if your vulvovaginitis is the result of an STI. All sexual partners should receive treatment for the condition, even if they’re not currently showing symptoms.
Most cases of vulvovaginitis heal quickly when properly treated. Return to your doctor if you don’t see an improvement within one week. You may find that alternative treatments are more effective.
Yeast infections and bacterial infections aren’t transmitted sexually. If your vulvovaginitis is caused by yeast or bacteria, it’s not necessary to abstain from sex during treatment.
But if you have an STI or virus, you should wait until you and your partner have completed treatment and are free of symptoms before resuming sex, according to the Mayo Clinic.
If yeast is causing your vulvovaginitis, you may find that the infection returns. Over-the-counter products can usually treat these infections.
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