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| |    Five Causes of Vaginitis by Marjorie Greenfield, M.D. reviewed and revised by Marjorie Greenfield, M.D. The most common gynecologic problem seen by physicians who care for women is vaginitis. Unfortunately, that's often just the tip of the iceberg, since many women with vaginal symptoms treat themselves with home remedies or over-the-counter medications rather than seek the help of their doctors. Almost every woman will have at least one episode of vaginitis in her lifetime, and many will have numerous bouts of itching, irritation, and/or discharge. Here is a list of the most common types of vaginitis, with a description of each and links to more detailed articles. Yeast vulvovaginitis Candida (pronounced CAN-did-uh) is a type of fungus commonly referred to as yeast. Although it is usually found on the skin and in the GI tract and vagina, on occasion it can invade the tissues of the vagina and cause severe inflammation. This type of yeast vaginal infection usually causes itching and a thick white discharge. Sometimes the only symptom is external or internal burning. Yeast infections are extremely common and can be totally miserable. The good news is that most of the time they can be treated easily. Bacterial vaginosis Bacterial vaginosis occurs when the normal, "good" bacteria of the vagina, lactobacilli, are overrun by "bad" bacteria. The most common symptom is a foul or fishy odor, often most noticeable after sexual intercourse. Some women will have a discharge, but for many the odor is the only indication that something is amiss. Trichomonas vaginitis Trichomonas is a one-celled organism that can cause a sexually transmitted infection. In men, the infection only lasts a few weeks and often is not associated with any symptoms. However, women can harbor the infection for years. Some will have accompanying symptoms of discharge and irritation, while others may be symptom free. Sometimes the diagnosis is only made after the organism shows up on a Pap smear, although if a woman comes in complaining of symptoms, her doctor or a lab technician can examine vaginal secretions under a microscope to determine the presence of trichomonas. Atrophic vaginitis Atrophic vaginitis, caused by estrogen deficiency, may lead to irritation, discharge, dryness, and discomfort with intercourse. Atrophic vaginitis occurs in women who are breastfeeding or who are postmenopausal and not taking estrogen. It does not occur in women who are menstruating monthly. Vaginal treatment with low dose estrogen cream, ring or pills can help the symptoms without much estrogen reaching the rest of the body. If there are also other reasons to use estrogen (and no medical reasons not to), systemic estrogen treatment, given in the form of pills, patch or systemic dose vaginal ring, can help to resolve the symptoms. Sometimes using a lubricant during intercourse is all that is needed. Irritant vulvitis Vulvitis--inflammation of the external vaginal area--can mimic vaginitis in its episodes of itching or irritation. Considering how often I see this problem in my practice, I'm amazed that so many women, and even doctors, seem to be unaware of it. The inflammation often is the result of the vulva's exposure to many potential irritants, including products that you may use on your underwear, soaps, feminine hygiene products, and condoms. Dryer sheets and fabric softeners are common culprits. To prevent as well as treat vulvitis, try to avoid use these potential irritants and exercise good vulvar care.
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