Potential causes of vulvovaginitis include:
Typically, the symptoms of vulvovaginitis affect both the vulva and vagina. How someone experiences the condition depends on the cause.
Causes of vulvovaginitis?
The types and causes of the condition include the following:
Bacterial vaginosis (BV)
Vulvovaginitis describes a range of conditions affecting the vulva and vagina.
Bacterial vaginosis or BV is the most common type of vulvovaginitis. Bacterial imbalances in the vagina cause the condition.
Any woman can get BV, and sexual activity does not usually play a role in its development, but it can.
BV prevalence in the United States is estimated to be 21.2 million, or 29 percent in females ages 14 to 49 years old, this is according to the Centers for Disease Control and Prevention (CDC).
Up to 84 percent of females with BV do not report any symptoms.
Yeast infections, including Candida infections, are common causes of vulvovaginitis. These infections are also called vulvovaginal candidiasis.
Yeast infections are not sexually transmitted infections (STIs).
Yeast infections affect up to 75 percent of the female population at least once in their lifetimes, and recurrences are not unusual. Recurrences are more common in those with immunodeficiency disorders, such as diabetes and lupus.
Trichomonas or trichomoniasis is an infection caused by a parasite and is usually spread through sexual contact, but not always.
The prevalence of trichomonas in the U.S. is believed to be around 2.3 million, or 3.1 percent, amongst girls and women, ages 14 to 49 years of age, according to the CDC.
Further causes of vulvovaginitis include:
- ingredients in soaps, lotions, and personal hygiene products, including douches
- heat rashes from tight-fitting or wet clothing
- chronic skin conditions
- reduced estrogen levels around the start of menopause or after childbirth
- foreign bodies, including lost tampons
- poor hygiene spread from bacteria in feces
Vulvovaginitis caused by poor hygiene tends to be more common in young girls who have not yet hit puberty. This may be due to poor hygiene practices that can transfer fecal bacteria to the vagina.
What are the symptoms?
Vulvovaginitis may cause pain during sexual activity.
General symptoms of vulvovaginitis include:
- redness or soreness
Some women may also experience:
- pain or discomfort with urination
- pain during sexual activity
- light bleeding outside monthly periods
- abnormal discharge
- odor, sometimes fishy smelling
What do odor and discharge say about the cause?
Discharge and odor distinguish the three causes of vulvovaginitis.
- Discharge with yeast infections is generally white and cottage cheese-like, but it does not have an odor. Yeast infections also cause itching.
- BV discharge is more substantial and may appear as a grey or green color. Its fishy smelling odor can distinguish BV.
- Trichomoniasis discharge may also have a fishy odor. The color of the discharge is a yellow-green color, and it appears foam-like.
When to see a doctor
Vulvovaginitis can be serious if not treated, although it is not generally a severe condition.
Seeing a doctor is the best way to determine what is happening and to get the right treatments because of the many causes, including sexual contact.
A doctor will make a diagnosis of vulvovaginitis based on symptoms and analysis of any vaginal discharge.
Carrying out a pelvic exam can also help with diagnosis. Pelvic exams involve physical and visual examination of the reproductive organs, including the vulva and vagina.
A doctor may test vaginal discharge with a wet prep test, also called a vaginal wet mount.
They may test vaginal pH as well, as raised pH levels can indicate BV or trichomoniasis. A doctor will apply a pH testing stick to the vaginal walls to check pH levels.
Once a doctor has decided the bacteria, yeast, or parasite source of the vulvovaginitis, they will diagnose the type of vulvovaginitis, and treatment can begin.
What are the treatment options?
Doctors usually prescribe medication to treat the causes of vulvovaginitis.
Treatments depend on the cause and include the following:
Treating BV involves an individual taking medications and applying gels and creams to the vulva and vagina.
Medications, such as metronidazole (available as a tablet or gel) or clindamycin (a cream) are only available with a doctor's prescription.
Yeast infection treatments
Treating yeast infections can be done with over-the-counter (OTC) antifungal creams and suppositories, such as miconazole, which is available under the brand name Monistat.
Doctors may treat yeast infections with prescription oral antifungal medications, including fluconazole (Diflucan). If they have diagnosed a yeast infection, they will probably prescribe fluconazole or another prescription antifungal.
A single dose of either metronidazole or tinidazole can treat and cure trichomoniasis, according to the CDC.
It is necessary to treat all sexual partners. They should also avoid sexual contact for at least a week, and until all symptoms are gone to prevent reinfection.
It is also essential to get rechecked if symptoms return.
Do home remedies work?
Mild cases of BV and yeast infections can go away without treatment or with home remedies. It may still be a good idea to see a doctor who can prescribe appropriate treatments, however.
Research has been done on natural remedies for BV and yeast infections, including yogurt, garlic, and boric acid.
Because yogurt contains good bacteria, eating it daily is an effective remedy for BV. Moreover, the probiotics in yogurt help maintain pH levels to minimize bad vaginal bacteria and yeast growth.
Garlic has been found to be similar to metronidazole in treating BV and does not cause side effects. It can be added to the diet or taken as a supplement to manage symptoms and prevent BV.
What do the studies say about home remedies?
Research from the Journal of Women's Health found that boric acid is a safe alternative for treating recurrent yeast infections. A person can apply it as a vaginal suppository before bedtime. It is a good idea to check with a doctor before starting boric acid treatment.
Treatment for vulvovaginitis depends on the cause, and some cases may go away without treatment.
Good hygiene is the best way to prevent non-infectious vulvovaginitis. Wearing comfortable clothing that absorbs moisture can also reduce infection. Using a condom can prevent most sexually transmitted forms of vulvovaginitis.
Adoption of good lifestyle habits, including a healthy diet, and management of all health conditions can also help avoid vulvovaginitis.