Recurrent vaginal infections

February 21, 2023

Providence Women's Health Team

[3 MIN READ]

Vaginal infections, or vaginitis, occur when the natural balance between yeast and beneficial bacteria in the vagina becomes unbalanced.
Vaginitis affects up to one-third of all women and people assigned female at birth. It is the top reason they seek care from an obstetrician-gynecologist.
A women’s health expert outlines the different types of vaginal infections and shares tips to help recognize and treat this common condition.

Vaginal infection, also known as vaginitis, affects up to one-third of women and people assigned female at birth. It is the most frequent reason they visit their obstetrician-gynecologist, according to the American College of Obstetricians and Gynecologists. And although it is a fairly common condition, many women either don’t recognize the symptoms or ignore them as long as possible.

As medical director of pelvic health for St. Jude Medical Center in Fullerton, California, Melanie Santos, M.D., FACOG, FPMRS, is an expert on health issues affecting women today. She explains the different types of vaginal infections and common causes and offers tips to help women recognize and treat this common condition.

What is vaginitis?

“Vaginitis refers to infection or inflammation of the vagina. It occurs when the natural balance between yeast and bacteria becomes unbalanced. This can lead to inflammation, swelling and infection of the vagina,” Says Dr. Santos.

Vaginitis does not always produce any noticeable symptoms, according to Dr. Santos. If recognizable symptoms do develop, they often include:

Vaginal burning and itching
Soreness and discomfort in and around the vagina
Inflamed, swollen skin
Changes in the amount, appearance or smell of vaginal discharge
Pain during sexual intercourse
Urinary burning or pain during urination
Vaginal spotting or bleeding

“Vaginal infections can occur at any age, but they are most common from late teens through early forties and can also increase after menopause. They are different than a sexually transmitted infection (STI). You can develop a vaginal infection without being active with sexual partners. However, some forms of sexual activity may trigger or worsen the condition,” she adds.

Types of vaginal infections

There are several different types of vaginal infections. Although they may share the characteristics listed above, each has unique signs, causes and treatments. Dr. Santos outlines the differences.

Bacterial vaginosis

Bacterial vaginosis (BV) is the most common vaginal infection in women ages 15 to 44. It occurs when there are too many harmful bacteria in the vagina, including an overgrowth of the typically normal vaginal bacteria. It often causes yellow or greenish discharge that may be watery or foamy. You may notice a strong fish-like odor that grows stronger after sex.

BV is not an STI, but sexual contact may boost bacteria growth and increase your chance of infection. Both male and female partners can spread this infection. Antibiotics are usually the main form of treatment, but other options can include alternative treatments that help bring balance top the normal vaginal flora.

Trichomoniasis

Trichomoniasis is caused by a parasite and spreads from person to person through sexual contact. It can cause swelling, irritation and inflammation in your vagina and vulva. Still, around 70% of people with trichomoniasis do not show any signs of infection, according to the Centers for Disease Control and Prevention (CDC).

Trichomoniasis can often be prevented with the correct use of condoms. Treatment typically includes antibiotics, which both you and your partner(s) must take. If left untreated, it could increase your risk of HIV.

Yeast infection

More than 75% of all women worldwide will experience a yeast infection and nearly half will have more than one in their lifetime, according to CDC reports. Yeast (candida) infections occur when there’s more yeast than antifungal bacteria in the vagina. In addition to the common symptoms, they may cause cottage cheese-like white discharge.

Several factors can increase the risk of infection, including stress, antibiotics, hormone changes or a compromised immune system.

Treatment for symptoms of a yeast infection varies according to the specifics of your condition. It often includes antifungal creams, ointments or suppositories. Your physician may prescribe oral medication in some cases.

Vaginal atrophy

Atrophic vaginitis, or vaginal atrophy, is not caused by an infection. However, it may lead to similar symptoms, including vaginal dryness, irritation, discharge and inflammation. Vaginal atrophy occurs most often after menopause when estrogen levels drop. Without estrogen, your vaginal tissue thins, loses moisture and becomes less elastic.

Various over-the-counter lubricants and moisturizers may help with vaginal dryness and discomfort. Your physician may prescribe hormone therapy, depending on your health history and symptoms.

Is it time to call your gynecologist?

“Don’t be afraid or embarrassed to talk to your physician about any symptoms you are having – especially if they cause you discomfort or begin affecting your health overall,” says Dr. Santos.

Contact your physician if you:

Experience unpleasant vaginal odor, pain during intercourse, vaginal itching or discharge
Develop symptoms and have multiple sex partners or a new sex partner, or feel you may be at risk for a sexually transmitted disease (STD)
Continue to have symptoms after treatment
Have chills, fever or pelvic pain
Notice vaginal bleeding after intercourse, between menstrual cycles or after menopause

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