Vaginal Infections

Your vagina naturally contains a diverse mix of microorganisms and good bacteria that help keep it healthy. This is called your normal vaginal flora.

Lactobacilli are the most common and important good bacteria in the vagina. They produce lactic acid, which keeps the vaginal environment slightly acidic with a low pH. This acidity helps prevent harmful bacteria, yeast, and other organisms from growing out of control.

Other bacteria are present in smaller amounts. These usually live in harmony with the lactobacilli unless something disturbs the balance.

What Disrupts the Balance?

Certain everyday situations can make vaginal infections more likely:

• Irritation or allergies. Scented soaps, bubble baths, or laundry detergents can irritate the delicate skin around the vagina, leading to tiny cracks or inflammation that allow bacteria or yeast to grow.
• Too much moisture. Wearing damp clothing or not changing pads often enough creates an environment where bacteria and yeast thrive.
• Changes in vaginal pH. The vagina is normally acidic to help keep harmful bacteria in check. Things like menopause, semen, or certain vaginal products can reduce this acidity and throw off the balance.
• Bacteria from the rectum. Wiping from back to front or poor hygiene can introduce bacteria into the vagina and increase the risk of infection.
• Weakened tissues. After childbirth, surgery, or cancer treatment, the vaginal tissues may be more vulnerable to infection.

What Are the Most Common Types of Vaginal Infections?

Vaginitis refers to inflammation or infection of the vagina. There are several common types that can cause discharge, itching, or irritation.

1. Yeast infection (candidiasis)

A yeast infection is caused by an overgrowth of a fungus called Candida, which normally lives in small amounts in the vagina. Symptoms may include:

• Thick, white, clumpy discharge, often compared to cottage cheese
• Intense itching
• Redness and swelling
• Pain during sex or urination
  Yeast infections are not sexually transmitted and are common, especially after taking antibiotics or during pregnancy.

2. Trichomoniasis

This is a sexually transmitted infection caused by a parasite called Trichomonas vaginalis. Symptoms may include:

• Frothy, greenish-yellow discharge
• Bad odor
• Itching, redness, or burning
• Pain during urination or sex

Many women with trichomoniasis have no symptoms, so regular sexually transmitted infection (STI) testing is important if you’re sexually active.

3. Bacterial vaginosis (BV)

Bacterial vaginosis is not a traditional infection, but rather a shift in the natural balance of bacteria in the vagina. With BV, the protective lactobacilli bacteria decrease, allowing other types of bacteria to grow too much.

This imbalance can lead to symptoms such as:

• Thin, gray or white vaginal discharge
• A strong, fishy odor, especially after sex
• Mild itching or irritation, though many women have no symptoms at all

BV is more common in sexually active women, but it is not considered an STI. However, sexual activity, especially with a new or multiple partners, can increase the risk of developing it.

4. Viral infections

Infections, like genital herpes, can cause symptoms that affect the vulva, the vagina, and the cervix. Herpes often causes painful blisters or sores, and some women may also notice a vaginal discharge during outbreaks.

Genital warts, caused by certain types of the human papillomavirus (HPV), typically affect the vulva, vagina, or cervix. While they don’t usually cause pain or discharge, their appearance and persistence may be the first sign of infection.

How Are Vaginal Infections Diagnosed?

If you notice changes in your discharge or have vaginal discomfort, see your doctor. You’ll be asked about your symptoms and sexual activity. A pelvic exam may be performed, and your doctor may take a sample of the discharge to examine under a microscope or send it for laboratory testing.

How Are Vaginal Infections Treated?

Treatment depends on the type of infection:

• Yeast infections are treated with antifungal creams, suppositories, or oral medication.
• Bacterial vaginosis responds to prescription antibiotics, usually as a pill or vaginal gel.
• Trichomoniasis is treated with specific antibiotics like metronidazole or tinidazole. Your partner should also be treated to prevent reinfection.
• Genital herpes is treated with antiviral medications like acyclovir or valacyclovir. They can be taken to reduce symptoms and prevent outbreaks, but will not fully eliminate the virus.
• Genital warts from HPV are treated by removing the warts with medications, freezing, or minor procedures. The HPV vaccine can help prevent certain strains of the virus.

Can Vaginal Infections Be Prevented?

Yes, some simple habits can help reduce your risk.

• Practicing good hygiene and avoiding douching and scented products will help maintain your natural vaginal balance.
• Wiping from front to back after using the bathroom prevents bacteria from the rectum from entering the vagina.
• Wearing breathable cotton underwear and changing out of wet clothes, like swimsuits or workout gear, can help keep the area dry.
• Using condoms can lower the risk of sexually transmitted infections.

Vaginal Infections FAQs

1. Can I treat a vaginal infection with over-the-counter products?

You can treat mild yeast infections with antifungal creams or suppositories available at most pharmacies. However, if you’re not sure it’s a yeast infection, or if your symptoms don’t improve, it’s best to see a doctor. This is because other vaginal infections, like BV and trichomoniasis, need prescription treatment.

2. Can vaginal discharge be caused by something other than a vaginal infection?

Yes. Sometimes discharge or discomfort is caused by an infection in the cervix, not the vagina itself. Sexually transmitted infections like chlamydia and gonorrhea can affect the cervix and still cause vaginal symptoms like discharge or pain during sex. If untreated, they can lead to pelvic inflammatory disease (PID), which may cause long-term pelvic pain or fertility problems.

3. What is non-infectious vaginitis?

Non-infectious vaginitis refers to vaginal irritation that isn’t caused by an infection. This includes irritation from products like soaps or laundry detergents, allergic reactions, or atrophic vaginitis. Atrophic vaginitis is a condition common after menopause caused by low estrogen levels, which make the vaginal walls thinner and drier.