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Vaginitis: Vaginal Itching, Dryness, or Irritation

by Marjorie Greenfield, M.D.
reviewed by Marjorie Greenfield, M.D.
Vaginitis is an inflammation of the vagina. Most women will experience at least one bout of vaginitis in their lifetime, and many are plagued with episodes of itching, irritation, or discharge. The term "vaginitis" indicates symptoms and signs of inflammation--like redness or discharge --but doesn't tell us the origin of the problem. Causes of vaginitis (or the related condition, vulvitis, which involves inflammation of the vaginal lips) include bacteria, protozoa, fungi, hormonal changes, contact with irritants, and true allergic reactions.

The connection between pH levels and bacteria
While you've probably never stopped to think about it, the vagina is an amazing organ. In the reproductive years, it must protect itself from infection if germs arrive, provide lubrication and sensation for intercourse, and be able to stretch open large enough to accommodate the birth of a full-term baby!

The function of the vagina changes through a woman's lifetime, from childhood through menopause and beyond, as the surface of the vagina responds to the hormonal changes that occur. In youth, when estrogen levels are low, the pH of the vagina is around 7 and the bacteria that live in the vagina are similar to those of the intestine. A child's vagina is not yet physiologically ready for intercourse and so is not as well protected as it will be later in life.

In adolescence and on into adulthood, under the influence of the hormone estrogen, the vaginal pH drops to around 4--a very acidic environment. This acidic pH protects the vagina from infection and promotes the growth of lactobacilli, the "good" bacteria that normally live there. The lactobacilli also help to prevent other sorts of bacteria from establishing themselves in the vagina.

A delicate balance
In fact, strange as it may sound, the vagina can be scientifically described as a delicately balanced ecosystem, with the habitat being the vaginal walls under the influence of hormones and the inhabitants being the lactobacilli. If antibiotics, a change in hormones, or douching disturb that system, the environment may favor the growth of other organisms that lead to inflammation and irritation.

The problem can be compounded when the lower genital tract is exposed to any number of potential irritants, including bubble bath, soaps, laundry detergent or fabric softener residue, feminine hygiene products, and latex condoms.

Preventive measures
  • Good vulvar care will prevent many cases of vaginitis. Many women who suffer from what they think are recurrent vaginal infections really have symptoms related to exposure to an irritant. To complicate matters, breaks in the skin or areas of inflammation can encourage the yeast organism that causes yeast vaginitis to set up shop. Preventing skin irritation can allay symptoms of vaginitis and prevent real yeast infections from developing.


  • Avoid douching. Douching is believed to wash the good bacteria out of the vagina and can upset normal vaginal pH levels.


  • Prevent rectal bacteria from entering the vagina. Back-to-front wiping after bowel movement or anal-then-vaginal sexual practices may deliver so many bacteria into the vagina that it overruns the protective lactobacilli, leading to bacterial vaginosis.


  • Use a condom. Condoms can protect against infection caused by the protozoan vaginitis called trichomonas and prevent many cases of herpes and papillomavirus (HPV) vulvar infections.

 RELATED INFORMATION
*  Urinary and Vaginal Symptoms During Pregnancy
*  Vaginitis


Created May 31, 2001
Reviewed August 26, 2004
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